Provider Demographics
NPI:1851079040
Name:CAMPBELL, ADAM WEBSTER (LCSW-A)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:WEBSTER
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 PINE AVE
Mailing Address - Street 2:
Mailing Address - City:CHERRYVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28021-3624
Mailing Address - Country:US
Mailing Address - Phone:704-616-7742
Mailing Address - Fax:
Practice Address - Street 1:1771 TATE BLVD SE STE 202
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-4250
Practice Address - Country:US
Practice Address - Phone:828-758-1320
Practice Address - Fax:828-758-1332
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-07
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0193131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty