Provider Demographics
NPI:1174113104
Name:SUZANNE CAMOS, LCSW PLLC
Entity type:Organization
Organization Name:SUZANNE CAMOS, LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:512-573-3784
Mailing Address - Street 1:100 E WHITESTONE BLVD STE 148-181
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-1906
Mailing Address - Country:US
Mailing Address - Phone:512-573-3784
Mailing Address - Fax:
Practice Address - Street 1:2515 JOHNATHAN WAY
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-3073
Practice Address - Country:US
Practice Address - Phone:512-573-3784
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-23
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty