Provider Demographics
NPI:1285827675
Name:CAMPBELL, RICHARD (LMSW, CAADC, ADS)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:LMSW, CAADC, ADS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:571 HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-2740
Mailing Address - Country:US
Mailing Address - Phone:616-566-4576
Mailing Address - Fax:
Practice Address - Street 1:607 HERITAGE CT
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-5481
Practice Address - Country:US
Practice Address - Phone:616-566-4576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical