Provider Demographics
NPI:1740246818
Name:CAMPOS, HECTOR M II (LCSW)
Entity type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:M
Last Name:CAMPOS
Suffix:II
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 NOEL DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-2501
Mailing Address - Country:US
Mailing Address - Phone:540-419-2719
Mailing Address - Fax:
Practice Address - Street 1:38 NOEL DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-2501
Practice Address - Country:US
Practice Address - Phone:540-419-2719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0004811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical