MEDICARE: CAMINITI COUNSELING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	2238	MS
2	101YP2500X	Professional Counselor	2238	MS

General Provider Information

NPI Number	:	1972004513
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAMINITI COUNSELING, LLC

Provider Business Mailing Address
First Line	:	276 PISTOL HOWELL RD
Second Line	:
City	:	LUCEDALE
State	:	MS
Zip	:	39452-9429
Country	:	US
Telephone Number	:	601-514-0088
Fax Number	:

Provider Business Practice Location Address
First Line	:	805 HOLCOMB BLVD
Second Line	:
City	:	OCEAN SPRINGS
State	:	MS
Zip	:	39564-3943
Country	:	US
Telephone Number	:	601-514-0088
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. DAVID ANTHONY CAMINITI
Credential	:	LPC
Telephone Number	:	601-514-0088

Provider Enumeration Date	:	02/27/2018
Last Update Date	:	07/09/2021

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