Provider Demographics
NPI:1003039546
Name:CAMPBELL, AMY PATTON (LMHC)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:PATTON
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 N CENTER PKWY STE 320
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-7160
Mailing Address - Country:US
Mailing Address - Phone:509-735-5081
Mailing Address - Fax:509-222-2223
Practice Address - Street 1:1030 N CENTER PKWY STE 320
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7160
Practice Address - Country:US
Practice Address - Phone:509-735-5081
Practice Address - Fax:509-222-2223
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00010420101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health