Provider Demographics
NPI:1669526828
Name:CAMPANA, JOHN ROBERT SR (LCSW, CAP, CEAP)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ROBERT
Last Name:CAMPANA
Suffix:SR
Gender:M
Credentials:LCSW, CAP, CEAP
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Mailing Address - Street 1:1408 N WEST SHORE BLVD
Mailing Address - Street 2:SUITE 502
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-4525
Mailing Address - Country:US
Mailing Address - Phone:813-281-8955
Mailing Address - Fax:813-281-2474
Practice Address - Street 1:1408 N WEST SHORE BLVD
Practice Address - Street 2:SUITE 502
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-4525
Practice Address - Country:US
Practice Address - Phone:813-281-8955
Practice Address - Fax:813-281-2474
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLSW72981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical