Provider Demographics
NPI:1528542131
Name:CAMPBELL, SHAYNA
Entity Type:Individual
Prefix:
First Name:SHAYNA
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 DOE RUN DR STE 5
Mailing Address - Street 2:
Mailing Address - City:MOUNT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-9097
Mailing Address - Country:US
Mailing Address - Phone:859-432-3055
Mailing Address - Fax:859-432-3044
Practice Address - Street 1:601 DOE RUN DR STE 5
Practice Address - Street 2:
Practice Address - City:MOUNT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-9097
Practice Address - Country:US
Practice Address - Phone:859-432-3055
Practice Address - Fax:859-432-3044
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional