Healthcare Provider Details

I. General information

NPI: 1114883527
Provider Name (Legal Business Name): KADIATU PAPA KAMARA LGSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2025
Last Update Date: 12/30/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

949 CITRINE WAY
ODENTON MD
21113-3851
US

IV. Provider business mailing address

949 CITRINE WAY
ODENTON MD
21113-3851
US

V. Phone/Fax

Practice location:
  • Phone: 443-422-7010
  • Fax:
Mailing address:
  • Phone: 443-422-7010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLG200004606
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: