Mental Wellness by Camila LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MENTAL WELLNESS BY CAMILA LLC

Practice address

79 SW 12TH St Apt 1702
Miami, FL 33130-5204

Phone

(310) 795-2528

NPI assigned

May 17, 2021

Organization subpart

No

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

Authorized official

Name

Camila R Quintero, LCSWNPI 1336739366

Title

Manager

Phone

(310) 795-2528

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Camila Regina Quintero, LCSW

  • Clinical Social Worker
  • Miami, FL
  • NPI 1336739366
  Medicare reassignment NPD Authorized official
• Rafael E Alfonzo, MD

  • Family Medicine Physician
  • Miami, FL
  • NPI 1497853741
  NPD (past)

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621209600000",
    "number": "1609440387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 SW 12TH ST APT 1702",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331305204",
            "telephone_number": "310-795-2528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 SW 12TH ST APT 1702",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331305204",
            "telephone_number": "310-795-2528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL WELLNESS BY CAMILA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-17",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A",
        "authorized_official_last_name": "QUINTERO",
        "authorized_official_first_name": "CAMILA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "310-795-2528",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Wellness Center
• Mental Wellness Center, Inc.
• Mental Wellness of Florida PA
• Mentally Psychiatry LLC
• Mentally Yours Family Counselors, Inc

• Clinical Social Worker in Miami, FL
• Providers in Miami, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.