Provider Demographics
NPI:1316031214
Name:CAMARATA, MIMI K (LCSW)
Entity type:Individual
Prefix:
First Name:MIMI
Middle Name:K
Last Name:CAMARATA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3606 MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:MOSS POINT
Mailing Address - State:MS
Mailing Address - Zip Code:39563-5137
Mailing Address - Country:US
Mailing Address - Phone:228-369-7968
Mailing Address - Fax:
Practice Address - Street 1:3606 MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:MOSS POINT
Practice Address - State:MS
Practice Address - Zip Code:39563-5137
Practice Address - Country:US
Practice Address - Phone:228-369-7968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC109521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical