Basic Information
| Provider Information | |||||||||
| NPI: | 1124553219 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CAMPBELL | ||||||||
| FirstName: | CAROL | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CAMPBELL, M.S, LPC | ||||||||
| OtherFirstName: | CAROL | ||||||||
| OtherMiddleName: | A. | ||||||||
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| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | CAROL A CAMPELL, MS., LPC | ||||||||
| Address2: | 313 WEST LIBERTY STREET, SUITE 144 | ||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 17603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7173402116 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 313 WEST LIBERTY STREET | ||||||||
| Address2: | SUITE 144 | ||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 17603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7173402116 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2017 | ||||||||
| LastUpdateDate: | 07/25/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | Y | Behavioral Health & Social Service Providers | Counselor | 101YP2500X | PC012546 | PA | N | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.