Provider Demographics
NPI:1558558965
Name:CAMPBELL, MARGY M (LCSW)
Entity Type:Individual
Prefix:
First Name:MARGY
Middle Name:M
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 E 4500 S
Mailing Address - Street 2:SUITE N160
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-3080
Mailing Address - Country:US
Mailing Address - Phone:801-281-1100
Mailing Address - Fax:801-281-1936
Practice Address - Street 1:716 E 4500 S
Practice Address - Street 2:SUITE N160
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-3080
Practice Address - Country:US
Practice Address - Phone:801-281-1100
Practice Address - Fax:801-281-1936
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-29
Last Update Date:2007-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT265455-3501101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health