Provider Demographics
NPI:1790342343
Name:CIABATTONI, CAMELLA (LMHC)
Entity type:Individual
Prefix:
First Name:CAMELLA
Middle Name:
Last Name:CIABATTONI
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:CAMELLA
Other - Middle Name:
Other - Last Name:HARVILLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:475 BLACKWATER RD
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:GA
Mailing Address - Zip Code:31562-2522
Mailing Address - Country:US
Mailing Address - Phone:407-227-7750
Mailing Address - Fax:904-765-0664
Practice Address - Street 1:2055 REYKO RD STE 100
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-2828
Practice Address - Country:US
Practice Address - Phone:239-690-6906
Practice Address - Fax:904-765-0664
Is Sole Proprietor?:No
Enumeration Date:2019-05-20
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH25397101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health