Individual provider Active NPI

Georgina Gonzalez Camacho, LPC, NCC

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1801839055
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
19031 Issued in TX
Practice address
3031 Ih 10 W
San Antonio, TX 78201-5159
Phone
(210) 731-1300
NPI assigned
Jun 14, 2006
Last updated
Aug 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 19031 TX Primary

Addresses

Primary practice location

3031 Ih 10 W
San Antonio, TX 78201-5159

Mailing address

9930 Sandlet TRL
San Antonio, TX 78254-5874
Phone (210) 724-6229

Other identifiers 1

IdentifierTypeStateIssuer
166620803MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260622002087 TX Practitioner - Mental Health Counselor 2860965852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

535 Mack Ave
Kingsley, MI 49649-9220

9930 Sandlet TRL
San Antonio, TX 78254-5874

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19031TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Professional Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: georginagonzalezcamacho@tdh.allscriptsdirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1801839055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9930 SANDLET TRL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782545874",
            "telephone_number": "210-724-6229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 IH 10 W",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782015159",
            "telephone_number": "210-731-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMACHO",
        "first_name": "GEORGINA",
        "middle_name": "GONZALEZ",
        "name_prefix": "Mrs.",
        "credential": "LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "19031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166620803",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.