Provider Demographics
NPI:1275705816
Name:CAMPBELL, SHAUNA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHAUNA
Middle Name:
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 1:3950 FAIRSTED DR APT 468
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-4558
Mailing Address - Country:US
Mailing Address - Phone:347-267-4758
Mailing Address - Fax:
Practice Address - Street 1:2815 CATES AVENUE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27695-2801
Practice Address - Country:US
Practice Address - Phone:919-515-2423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-24
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical