Provider Demographics
NPI:1437640398
Name:CAMPBELL, SHERYL B (LCPC)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:B
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1042 5TH ST
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-6712
Mailing Address - Country:US
Mailing Address - Phone:443-986-1723
Mailing Address - Fax:
Practice Address - Street 1:1114 BENFIELD BLVD STE G
Practice Address - Street 2:
Practice Address - City:MILLERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21108-2589
Practice Address - Country:US
Practice Address - Phone:410-780-5203
Practice Address - Fax:410-987-4301
Is Sole Proprietor?:No
Enumeration Date:2018-05-25
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC8120101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional