Provider Demographics
NPI:1093599862
Name:CAMPBELL, ANDREA (LMFT-T)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LMFT-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1432 N 64TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66102-1114
Mailing Address - Country:US
Mailing Address - Phone:210-780-2278
Mailing Address - Fax:
Practice Address - Street 1:7840 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-2152
Practice Address - Country:US
Practice Address - Phone:913-563-6500
Practice Address - Fax:913-328-4604
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS03502-T106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist