Provider Demographics
NPI:1609071638
Name:CAMPBELL, CAMILLE ANNE (LPC)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:ANNE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7027 MILNE BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-2341
Mailing Address - Country:US
Mailing Address - Phone:504-288-7762
Mailing Address - Fax:504-288-7629
Practice Address - Street 1:7027 MILNE BLVD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70124-2341
Practice Address - Country:US
Practice Address - Phone:504-288-7762
Practice Address - Fax:504-288-7629
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1504101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional