Provider Demographics
NPI:1902417751
Name:CAMPBELL, KATHERINE (LPC-S, LASAC, NCC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LPC-S, LASAC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6950 E GOLF LINKS RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85730-1017
Mailing Address - Country:US
Mailing Address - Phone:520-309-3229
Mailing Address - Fax:
Practice Address - Street 1:6950 E GOLF LINKS RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85730-1017
Practice Address - Country:US
Practice Address - Phone:520-309-3229
Practice Address - Fax:520-309-3334
Is Sole Proprietor?:No
Enumeration Date:2020-08-14
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-19176101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZLPC-19176OtherAZ BOARD OF BEHAVIORAL HEALTH EXAMINERS