Provider Demographics
NPI:1578780409
Name:CAMPBELL, LLOYD NELSON (LCSW)
Entity Type:Individual
Prefix:MR
First Name:LLOYD
Middle Name:NELSON
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22827 SW HOSLER WAY
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-7745
Mailing Address - Country:US
Mailing Address - Phone:503-625-9891
Mailing Address - Fax:503-620-3940
Practice Address - Street 1:7080 SW FIR LOOP
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8149
Practice Address - Country:US
Practice Address - Phone:503-620-1191
Practice Address - Fax:503-620-3940
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL27691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical