Provider Demographics
NPI:1942432448
Name:CAMPBELL, SHARON L (LPC)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:L
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1634 WALNUT ST
Mailing Address - Street 2:SUITE 221
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-5400
Mailing Address - Country:US
Mailing Address - Phone:303-829-3975
Mailing Address - Fax:
Practice Address - Street 1:1634 WALNUT ST
Practice Address - Street 2:SUITE 221
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5400
Practice Address - Country:US
Practice Address - Phone:303-829-3975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-17
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO191101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional