Provider Demographics
NPI:1275977217
Name:KAMARA, FATMATA TITY (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:FATMATA
Middle Name:TITY
Last Name:KAMARA
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 FAIRBANKS DR
Mailing Address - Street 2:330
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-6335
Mailing Address - Country:US
Mailing Address - Phone:240-264-0172
Mailing Address - Fax:
Practice Address - Street 1:205 FAIRBANKS DR
Practice Address - Street 2:330
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-6335
Practice Address - Country:US
Practice Address - Phone:240-264-0172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD145931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical