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General NPI Number Information
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NPI Number | 1790342343
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Entity Type | Individual
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Provider Name | CAMELLA CIABATTONI LMHC
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Gender | Female
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Dates
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Enumeration Date | 05/20/2019
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 2055 REYKO RD STE 100
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City | JACKSONVILLE
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State | FL
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Zip | 32207-2828
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Country | US
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Telephone | 239-690-6906
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Fax | 904-765-0664
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Provider Business Mailing Address
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Address Line | 475 BLACKWATER RD
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City | SAINT GEORGE
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State | GA
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Zip | 31562-2522
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Country | US
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Telephone | 407-227-7750
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Fax | 904-765-0664
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH25397
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License Number State | FL
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