Provider Demographics
NPI:1629161153
Name:OBEID-CAMPBELL, JENNIFER KRISTA (MS LMHC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:KRISTA
Last Name:OBEID-CAMPBELL
Suffix:
Gender:F
Credentials:MS LMHC
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:KRISTA
Other - Last Name:OBEID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:413 N MAIN ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-3183
Mailing Address - Country:US
Mailing Address - Phone:509-925-4400
Mailing Address - Fax:509-925-4404
Practice Address - Street 1:413 N MAIN ST
Practice Address - Street 2:SUITE D
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-3183
Practice Address - Country:US
Practice Address - Phone:509-925-4400
Practice Address - Fax:509-925-4404
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00009914101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health