Provider Demographics
NPI:1659771491
Name:CAMPBELL TEMPLE, DORIAN (MS, LGPC, MT-BC)
Entity Type:Individual
Prefix:
First Name:DORIAN
Middle Name:
Last Name:CAMPBELL TEMPLE
Suffix:
Gender:F
Credentials:MS, LGPC, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 N CARROLL ST
Mailing Address - Street 2:
Mailing Address - City:THURMONT
Mailing Address - State:MD
Mailing Address - Zip Code:21788-4942
Mailing Address - Country:US
Mailing Address - Phone:443-297-9422
Mailing Address - Fax:
Practice Address - Street 1:143 N CARROLL ST
Practice Address - Street 2:
Practice Address - City:THURMONT
Practice Address - State:MD
Practice Address - Zip Code:21788-4942
Practice Address - Country:US
Practice Address - Phone:443-297-9422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-29
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP11894101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health