Provider Demographics
NPI:1851958771
Name:CAMARA, KANKOU (CSW)
Entity type:Individual
Prefix:
First Name:KANKOU
Middle Name:
Last Name:CAMARA
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 DELRAN PL
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-5717
Mailing Address - Country:US
Mailing Address - Phone:240-550-9994
Mailing Address - Fax:
Practice Address - Street 1:913 DELRAN PL
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-5717
Practice Address - Country:US
Practice Address - Phone:240-550-9994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-27
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator