Provider Demographics
NPI:1811104367
Name:CAMPBELL, SCOTT D (LMFT)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:D
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7345 164TH AVE NE
Mailing Address - Street 2:STE I145-1410
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-7846
Mailing Address - Country:US
Mailing Address - Phone:833-733-0073
Mailing Address - Fax:888-655-4275
Practice Address - Street 1:7345 164TH AVE NE
Practice Address - Street 2:STE I145-1410
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-7846
Practice Address - Country:US
Practice Address - Phone:833-733-0073
Practice Address - Fax:888-655-4275
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2023-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00002455101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health