Provider Demographics
NPI:1578141982
Name:CAMPBELL, CLAY (CADC)
Entity Type:Individual
Prefix:
First Name:CLAY
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1152 LENOIR RHYNE BLVD SE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-5168
Mailing Address - Country:US
Mailing Address - Phone:828-485-1320
Mailing Address - Fax:828-485-1326
Practice Address - Street 1:1152 LENOIR RHYNE BLVD SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-5168
Practice Address - Country:US
Practice Address - Phone:828-485-1320
Practice Address - Fax:828-485-1326
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCADC-2927101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)