Organization · NPI-2

Brenda Gonzalez Camacho Lcsw

Social Worker, Clinical · Port Charlotte, FL

NPI number1871034025
StatusActive
Last updated in NPPESMar 20, 2017

Details

NPI
1871034025
Entity type
Organization (NPI-2)
Legal business name
Brenda Gonzalez Camacho Lcsw
Organization subpart
No
Enumeration date
Mar 20, 2017
Last updated
Mar 20, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, ClinicalSW8837FLYes

Practice location

22099 Elmira Blvd
Port Charlotte, FL 33952-7018

Phone 941-613-1356 · Fax 941-613-1591

Mailing address

22099 Elmira Blvd
Port Charlotte, FL 33952-7018

Phone 941-613-1356 · Fax 941-613-1591

Authorized official

Brenda Gonzalez Camacho
President
9416131356

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Social Worker, Clinical providers in Port Charlotte, FL