Provider Demographics
NPI:1114734795
Name:KAMARA, CATHERINE T (LSW, MSW)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:T
Last Name:KAMARA
Suffix:
Gender:F
Credentials:LSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-2926
Mailing Address - Country:US
Mailing Address - Phone:267-709-5022
Mailing Address - Fax:
Practice Address - Street 1:201 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-2926
Practice Address - Country:US
Practice Address - Phone:267-709-5022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW142241104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty