Provider Demographics
NPI:1285850024
Name:CAMPBELL, JULIE R (LISW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:R
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:R
Other - Last Name:STEMEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:4449 STATE ROUTE 159
Mailing Address - Street 2:P.O. BOX 6179
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-8620
Mailing Address - Country:US
Mailing Address - Phone:740-775-1260
Mailing Address - Fax:740-773-1264
Practice Address - Street 1:145 MORRIS RD
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-1363
Practice Address - Country:US
Practice Address - Phone:740-474-8874
Practice Address - Fax:740-477-1463
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 00101231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCASW34054Medicare UPIN
OHCASW34053Medicare UPIN
OHCASW34052Medicare UPIN
OHCASW34051Medicare UPIN
OHCASW34055Medicare UPIN