Provider Demographics
NPI:1770956419
Name:CAMPBELL, ALETHA
Entity type:Individual
Prefix:
First Name:ALETHA
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 CHANCERY ST
Mailing Address - Street 2:314 CHANCERY STREET
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-4219
Mailing Address - Country:US
Mailing Address - Phone:508-863-2697
Mailing Address - Fax:
Practice Address - Street 1:314 CHANCERY ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-4219
Practice Address - Country:US
Practice Address - Phone:508-863-2697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor