Provider Demographics
NPI:1982845798
Name:CAMPBELL, JUDITH V (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:V
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2339 CEDAR RDG
Mailing Address - Street 2:SUITE 4
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54313-5700
Mailing Address - Country:US
Mailing Address - Phone:920-497-6161
Mailing Address - Fax:920-498-0476
Practice Address - Street 1:2339 CEDAR RDG
Practice Address - Street 2:SUITE 4
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54313-5700
Practice Address - Country:US
Practice Address - Phone:920-497-6161
Practice Address - Fax:920-498-0476
Is Sole Proprietor?:No
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI524-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional