Provider Demographics
NPI:1265867220
Name:CAMPBELL, ELANA CARISSA (MSW, LCSWA)
Entity type:Individual
Prefix:MRS
First Name:ELANA
Middle Name:CARISSA
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:MS
Other - First Name:ELANA
Other - Middle Name:CARISSA
Other - Last Name:ZIPKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSWA
Mailing Address - Street 1:6251 E VIRGINIA BEACH BLVD STE 401
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-2800
Mailing Address - Country:US
Mailing Address - Phone:757-624-0420
Mailing Address - Fax:833-406-3992
Practice Address - Street 1:6251 E VIRGINIA BEACH BLVD STE 401
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-2800
Practice Address - Country:US
Practice Address - Phone:757-624-0420
Practice Address - Fax:833-406-3992
Is Sole Proprietor?:No
Enumeration Date:2013-09-10
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP008124104100000X
VA09040096371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker