Provider Demographics
NPI:1689094385
Name:CAMPBELL, JAMES BURTON (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BURTON
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7501 NW 4TH ST
Mailing Address - Street 2:SUITE 215
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2245
Mailing Address - Country:US
Mailing Address - Phone:954-707-9391
Mailing Address - Fax:954-587-0982
Practice Address - Street 1:7501 NW 4TH ST
Practice Address - Street 2:SUITE 215
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2245
Practice Address - Country:US
Practice Address - Phone:954-707-9391
Practice Address - Fax:954-587-0982
Is Sole Proprietor?:No
Enumeration Date:2014-04-21
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 8968103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical