NPIMap

Organization Active NPI

Brenda Gonzalez Camacho LCSW

  • Clinical Social Worker
  • Port Charlotte, FL
National Provider Identifier
1871034025
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW8837 Issued in FL
Legal business name
BRENDA GONZALEZ CAMACHO LCSW
Practice address
22099 Elmira Blvd
Port Charlotte, FL 33952-7018
Phone
(941) 613-1356
Fax
(941) 613-1591
NPI assigned
Mar 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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

Authorized official

Name
Brenda Gonzalez Camacho, LCSWNPI 1134399942
Title
President
Phone
(941) 613-1356

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X SW8837 FL Primary

Addresses

Primary practice location

22099 Elmira Blvd
Port Charlotte, FL 33952-7018

Mailing address

22099 Elmira Blvd
Port Charlotte, FL 33952-7018
Phone (941) 613-1356

National Provider Directory

National Provider Directory

Locations

22099 Elmira Blvd
Pt Charlotte, FL 33952
Phone (941) 613-1356

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489968000000",
    "number": "1871034025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22099 ELMIRA BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339527018",
            "telephone_number": "941-613-1356",
            "fax_number": "941-613-1591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22099 ELMIRA BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339527018",
            "telephone_number": "941-613-1356",
            "fax_number": "941-613-1591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENDA GONZALEZ CAMACHO LCSW",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-20",
        "last_updated": "2017-03-20",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ CAMACHO",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-613-1356",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW8837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.