Provider Demographics
NPI:1700351483
Name:CAMPBELL, WILLIAM C (LPC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:C
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1634 BUNCH LN
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-6667
Mailing Address - Country:US
Mailing Address - Phone:252-347-5705
Mailing Address - Fax:
Practice Address - Street 1:1634 BUNCH LN
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-6667
Practice Address - Country:US
Practice Address - Phone:252-347-5705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-09
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10812101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional