Healthcare Provider Details

I. General information

NPI: 1548808363
Provider Name (Legal Business Name): KATHERINE CAMONI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2019
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 EDEN RD
LANCASTER PA
17601-4713
US

IV. Provider business mailing address

451 WEST CHEW ST.
ALLENTWON PA
18102
US

V. Phone/Fax

Practice location:
  • Phone: 570-606-8664
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW026170
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: