Provider Demographics
NPI:1669463733
Name:CAMPBELL, JOETTE SCOTT (LCSWR)
Entity Type:Individual
Prefix:MS
First Name:JOETTE
Middle Name:SCOTT
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:MS
Other - First Name:JOETTE
Other - Middle Name:SCOTT
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSWR
Mailing Address - Street 1:11 SAMPSON ST
Mailing Address - Street 2:
Mailing Address - City:OYSTER BAY
Mailing Address - State:NY
Mailing Address - Zip Code:11771-2905
Mailing Address - Country:US
Mailing Address - Phone:516-922-6695
Mailing Address - Fax:
Practice Address - Street 1:11 SAMPSON ST
Practice Address - Street 2:
Practice Address - City:OYSTER BAY
Practice Address - State:NY
Practice Address - Zip Code:11771-2905
Practice Address - Country:US
Practice Address - Phone:516-922-6695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR013264-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical