Provider Demographics
NPI:1700222122
Name:CAMPBELL, JUNIPER (LPC)
Entity Type:Individual
Prefix:MS
First Name:JUNIPER
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1756 E. VILLA DR.
Mailing Address - Street 2:SUITE B2
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326
Mailing Address - Country:US
Mailing Address - Phone:928-254-0113
Mailing Address - Fax:928-547-5178
Practice Address - Street 1:1756 E. VILLA DR.
Practice Address - Street 2:SUITE B2
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326
Practice Address - Country:US
Practice Address - Phone:928-254-0113
Practice Address - Fax:928-547-5178
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-13
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-15211101YM0800X
AZ13772101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health