Provider Demographics
NPI:1710234059
Name:CAMPBELL, JANET MARIE (LCSWA, LCAS-R)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:MARIE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LCSWA, LCAS-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 243
Mailing Address - Street 2:HWY 71 S 8236
Mailing Address - City:RED SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:28377-0243
Mailing Address - Country:US
Mailing Address - Phone:910-316-8807
Mailing Address - Fax:
Practice Address - Street 1:22421 ANDREW JACKSON HWY
Practice Address - Street 2:
Practice Address - City:MAXTON
Practice Address - State:NC
Practice Address - Zip Code:28364-6721
Practice Address - Country:US
Practice Address - Phone:910-844-2008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-06
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0069131041C0700X
NCLCAS-25582101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical