Provider Demographics
NPI:1073306015
Name:MCCAMPBELL, SKYLAR VIRGINIA (LCSW, SAC)
Entity type:Individual
Prefix:
First Name:SKYLAR
Middle Name:VIRGINIA
Last Name:MCCAMPBELL
Suffix:
Gender:F
Credentials:LCSW, SAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 LYON ST
Mailing Address - Street 2:
Mailing Address - City:NANTUCKET
Mailing Address - State:MA
Mailing Address - Zip Code:02554-3921
Mailing Address - Country:US
Mailing Address - Phone:978-886-7928
Mailing Address - Fax:
Practice Address - Street 1:4 LYON ST
Practice Address - Street 2:
Practice Address - City:NANTUCKET
Practice Address - State:MA
Practice Address - Zip Code:02554-3921
Practice Address - Country:US
Practice Address - Phone:978-886-7928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA80057211041S0200X
MALCSW230838104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool