Provider Demographics
NPI:1386844033
Name:CAMPBELL, HEATHER LYN (MSW, PLMHP)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:LYN
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MSW, PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 MATHEWSON ST.
Mailing Address - Street 2:PO BOX 94
Mailing Address - City:WALTHILL
Mailing Address - State:NE
Mailing Address - Zip Code:68067
Mailing Address - Country:US
Mailing Address - Phone:402-846-5759
Mailing Address - Fax:
Practice Address - Street 1:301 MATHEWSON ST.
Practice Address - Street 2:
Practice Address - City:WALTHILL
Practice Address - State:NE
Practice Address - Zip Code:68067
Practice Address - Country:US
Practice Address - Phone:402-846-5759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE80271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical