Provider Demographics
NPI:1023687571
Name:CAMPBELL, JANET (LPC, LPN)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LPC, LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4380 W 12TH ST STE 3A
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-3028
Mailing Address - Country:US
Mailing Address - Phone:814-881-8277
Mailing Address - Fax:814-833-3019
Practice Address - Street 1:4380 W 12TH ST STE 3A
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-3028
Practice Address - Country:US
Practice Address - Phone:814-881-5277
Practice Address - Fax:814-833-3019
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-20
Last Update Date:2021-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC013400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional