Camila A Moore, M.ED.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

122 Desoto Ave Ste 109
Clarksdale, MS 38614-4440

Phone

(662) 592-5397

Fax

(662) 627-2442

NPI assigned

Aug 9, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Delta Compassionate Care Counseling

  • Adolescent and Children Mental Health Clinic/Center
  • Clarksdale, MS
  • NPI 1083437958
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1316426430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 DESOTO AVE STE 109",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386144440",
            "telephone_number": "662-592-5397",
            "fax_number": "662-627-2442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 DESOTO AVE STE 109",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386144440",
            "telephone_number": "662-592-5397",
            "fax_number": "662-627-2442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CAMILA",
        "middle_name": "A",
        "credential": "M.ED.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-09",
        "last_updated": "2023-06-15",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connie Mitchell, MSW
• MJC Dental, PLLC (Crossroads Family Dentistry)
• Gowdhami Mohan, MD
• Rolanda Mohead, MSW, CMHT
• Arlena Francisco Moore, M.ED.
• Lashea R Moore
• Lukesha Shonnet Morris
• Kim Morrison
• Carolyn Alecia Moten, M.S.W.
• Ms Greenbough LLC (Greenbough Health and Rehabilitation Center)

• Mental Health Counselor in Clarksdale, MS
• Providers in Clarksdale, MS by specialty
• Mental Health Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.