Provider Demographics
NPI:1407258221
Name:CAMPBELL, SARA J (LISW-S)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:J
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 N 6TH AVE
Mailing Address - Street 2:COLEMAN PROFESSIONAL SERVICES
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952
Mailing Address - Country:US
Mailing Address - Phone:740-996-7100
Mailing Address - Fax:
Practice Address - Street 1:740 N 6TH AVE
Practice Address - Street 2:COLEMAN PROFESSIONAL SERVICES
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952
Practice Address - Country:US
Practice Address - Phone:740-996-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.15005721041C0700X
OHI.1500572-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical