Provider Demographics
NPI:1841034485
Name:CAMPBELL, MARIAH KAY (LMHC)
Entity type:Individual
Prefix:
First Name:MARIAH
Middle Name:KAY
Last Name:CAMPBELL
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:MARIAH
Other - Middle Name:KAY
Other - Last Name:SPEAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:149 CHESSER RESERVE DR
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:AL
Mailing Address - Zip Code:35043-8601
Mailing Address - Country:US
Mailing Address - Phone:765-810-8608
Mailing Address - Fax:
Practice Address - Street 1:5205 GREENWOOD AVE STE 105
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2400
Practice Address - Country:US
Practice Address - Phone:561-224-9499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-19
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH24962101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health