Provider Demographics
NPI:1518226364
Name:CAMPBELL, ROBERT DWIGHT (MSW)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:DWIGHT
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 COLONIAL RD STE 100
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-5309
Mailing Address - Country:US
Mailing Address - Phone:772-486-4726
Mailing Address - Fax:772-489-0423
Practice Address - Street 1:2222 COLONIAL RD STE 100
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-5309
Practice Address - Country:US
Practice Address - Phone:772-486-4726
Practice Address - Fax:772-489-0423
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-15
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor