Provider Demographics
NPI:1508756479
Name:EQUILIBRIUM MINDSCAPE LLC
Entity type:Organization
Organization Name:EQUILIBRIUM MINDSCAPE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMERO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:540-429-3358
Mailing Address - Street 1:21 ROSEDALE DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22556-6215
Mailing Address - Country:US
Mailing Address - Phone:540-300-2051
Mailing Address - Fax:
Practice Address - Street 1:21 ROSEDALE DR
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22556-6215
Practice Address - Country:US
Practice Address - Phone:540-300-2051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-03
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty