Provider Demographics
NPI:1437796935
Name:CAMPANILE, VINCENT JAMES IV (LPC, MA, MS, NCC)
Entity Type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:JAMES
Last Name:CAMPANILE
Suffix:IV
Gender:M
Credentials:LPC, MA, MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 REED AVE STE 900
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-2002
Mailing Address - Country:US
Mailing Address - Phone:610-939-9999
Mailing Address - Fax:
Practice Address - Street 1:1011 REED AVE STE 900
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-2002
Practice Address - Country:US
Practice Address - Phone:610-939-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-03
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011990101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health