Provider Demographics
NPI:1255302048
Name:CAMPBELL, PAULA ANN (MSW, LISW)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:ANN
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 MIDWAY BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-9006
Mailing Address - Country:US
Mailing Address - Phone:440-324-5555
Mailing Address - Fax:440-324-5512
Practice Address - Street 1:347 MIDWAY BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-9006
Practice Address - Country:US
Practice Address - Phone:440-324-5555
Practice Address - Fax:440-324-5512
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00043041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical