Provider Demographics
NPI:1851456446
Name:CAMPBELL, DEBORAH THOMAS (LPC, M DIV, CAC)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:THOMAS
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LPC, M DIV, CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 16TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-1461
Mailing Address - Country:US
Mailing Address - Phone:202-289-1510
Mailing Address - Fax:202-518-8924
Practice Address - Street 1:1509 16TH ST NW
Practice Address - Street 2:M-23
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1461
Practice Address - Country:US
Practice Address - Phone:202-289-1510
Practice Address - Fax:202-518-8924
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC799101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor