Provider Demographics
NPI:1265783559
Name:CAMPBELL, EMILY CAROL (PHD, LPCA, NCC)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:CAROL
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:PHD, LPCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:NC
Mailing Address - Zip Code:28753-1007
Mailing Address - Country:US
Mailing Address - Phone:828-649-9174
Mailing Address - Fax:828-649-9161
Practice Address - Street 1:13 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:NC
Practice Address - Zip Code:28753-1007
Practice Address - Country:US
Practice Address - Phone:828-649-9174
Practice Address - Fax:828-649-9161
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-26
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA9607101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCA9607OtherNORTH CAROLINA LICENSING BOARD FOR PROFESSIONAL COUNSELORS