Provider Demographics
NPI:1174677843
Name:CAMACHO, IRMA M (LMFT)
Entity type:Individual
Prefix:MS
First Name:IRMA
Middle Name:M
Last Name:CAMACHO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 POPES ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06461-1760
Mailing Address - Country:US
Mailing Address - Phone:203-394-1135
Mailing Address - Fax:
Practice Address - Street 1:712 POPES ISLAND RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06461-1760
Practice Address - Country:US
Practice Address - Phone:203-394-1135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000610106H00000X
CT610106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist