Provider Demographics
NPI:1043937279
Name:CAMPBELL, ALLISON J (MS ,LCPC)
Entity Type:Individual
Prefix:MISS
First Name:ALLISON
Middle Name:J
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MS ,LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 S LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:MILES CITY
Mailing Address - State:MT
Mailing Address - Zip Code:59301-4535
Mailing Address - Country:US
Mailing Address - Phone:406-853-3041
Mailing Address - Fax:
Practice Address - Street 1:2911 WILSON ST
Practice Address - Street 2:
Practice Address - City:MILES CITY
Practice Address - State:MT
Practice Address - Zip Code:59301-5722
Practice Address - Country:US
Practice Address - Phone:406-234-2929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-27
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-57550101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health