Provider Demographics
NPI:1922747567
Name:CAMPBELL, CHERI M (LMHC)
Entity Type:Individual
Prefix:
First Name:CHERI
Middle Name:M
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:
Other - Last Name:AMET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:8716 CHRISTA DR NE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98516-7133
Mailing Address - Country:US
Mailing Address - Phone:360-791-5210
Mailing Address - Fax:
Practice Address - Street 1:8716 CHRISTA DR NE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98516-7133
Practice Address - Country:US
Practice Address - Phone:360-791-5210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00005838101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health