Provider Demographics
NPI:1417493354
Name:CAMPBELL, JOSEPH PAUL (LCSW)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:PAUL
Last Name:CAMPBELL
Suffix:
Gender:M
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:PO BOX 568
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40702-0568
Mailing Address - Country:US
Mailing Address - Phone:606-528-7010
Mailing Address - Fax:
Practice Address - Street 1:311 W 5TH ST
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-1841
Practice Address - Country:US
Practice Address - Phone:606-401-2966
Practice Address - Fax:606-244-4111
Is Sole Proprietor?:No
Enumeration Date:2017-01-17
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY255374101YP2500X, 1041C0700X
KY165293101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)