Provider Demographics
NPI:1821248188
Name:CAMPBELL, GHAZAL ZARGHAM (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:GHAZAL
Middle Name:ZARGHAM
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 E RIDGEWOOD AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3862
Mailing Address - Country:US
Mailing Address - Phone:201-444-3313
Mailing Address - Fax:201-444-3321
Practice Address - Street 1:215 E RIDGEWOOD AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3862
Practice Address - Country:US
Practice Address - Phone:201-444-3313
Practice Address - Fax:201-444-3321
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC005269001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical