Provider Demographics
NPI:1497890412
Name:CAMPBELL, CHERYL D (LMHP)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:D
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6663 SORENSEN PKWY
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68152-2139
Mailing Address - Country:US
Mailing Address - Phone:402-453-6869
Mailing Address - Fax:402-453-6768
Practice Address - Street 1:6663 SORENSEN PKWY
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68152-2139
Practice Address - Country:US
Practice Address - Phone:402-453-6869
Practice Address - Fax:402-453-6768
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3031101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health