Provider Demographics
NPI:1093992364
Name:CAMPBELL, NANCY E (LCSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:E
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 SIMMONS CIR.
Mailing Address - Street 2:
Mailing Address - City:EXPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15632
Mailing Address - Country:US
Mailing Address - Phone:520-878-7857
Mailing Address - Fax:520-572-2049
Practice Address - Street 1:4901 SIMMONS CIR.
Practice Address - Street 2:
Practice Address - City:EXPORT
Practice Address - State:PA
Practice Address - Zip Code:15632
Practice Address - Country:US
Practice Address - Phone:520-878-7857
Practice Address - Fax:520-572-2049
Is Sole Proprietor?:No
Enumeration Date:2008-01-29
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0158471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1995720OtherBLUE SHIELD
PA1995720OtherBLUE SHIELD