Provider Demographics
NPI:1033403928
Name:CAMPBELL, LINDA S (NCC, LPC)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:S
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1258 PURDYTOWN TPKE STE 101
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18438-6793
Mailing Address - Country:US
Mailing Address - Phone:570-470-6190
Mailing Address - Fax:570-226-1967
Practice Address - Street 1:1258 PURDYTOWN TPKE STE 101
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:PA
Practice Address - Zip Code:18438-6793
Practice Address - Country:US
Practice Address - Phone:570-470-6190
Practice Address - Fax:570-226-1967
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC001562101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1487071247OtherNPI 2
PA1033403928OtherNPI 1