Provider Demographics
NPI:1639926280
Name:CAMPBELL-MASSALEE, MARJUIN VELDA (LCSW-C)
Entity type:Individual
Prefix:
First Name:MARJUIN
Middle Name:VELDA
Last Name:CAMPBELL-MASSALEE
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2706 CHELSEA TER
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21216-1725
Mailing Address - Country:US
Mailing Address - Phone:410-491-6986
Mailing Address - Fax:
Practice Address - Street 1:2706 CHELSEA TER
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21216-1725
Practice Address - Country:US
Practice Address - Phone:443-928-5704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical