Provider Demographics
NPI:1043781891
Name:CAMPBELL, PAIGE MARIE (LPCA)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:MARIE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3718 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-9049
Mailing Address - Country:US
Mailing Address - Phone:336-455-0483
Mailing Address - Fax:
Practice Address - Street 1:520A ARBOR HILL RD
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-3346
Practice Address - Country:US
Practice Address - Phone:336-455-0483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA14033101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional