Provider Demographics
NPI:1245305739
Name:CAMPBELL, SHARON (LISW, CP-AP)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LISW, CP-AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 WOODWIND CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29209-4235
Mailing Address - Country:US
Mailing Address - Phone:809-898-4566
Mailing Address - Fax:
Practice Address - Street 1:1825 SUMTER STREET
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201
Practice Address - Country:US
Practice Address - Phone:803-771-6330
Practice Address - Fax:803-771-6331
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2020-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC54281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical