Provider Demographics
NPI:1437379955
Name:CAMPBELL, CATHY (LPC)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1744 N WALNUT AVENUE
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-2630
Mailing Address - Country:US
Mailing Address - Phone:479-236-7676
Mailing Address - Fax:844-862-1196
Practice Address - Street 1:65 E. SUNBRIDGE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-2894
Practice Address - Country:US
Practice Address - Phone:479-236-7676
Practice Address - Fax:844-862-1196
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR99-3E101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional