Provider Demographics
NPI:1841339975
Name:CAMPBELL, REED CHARLES (MA LIMHP LADC)
Entity type:Individual
Prefix:MR
First Name:REED
Middle Name:CHARLES
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:MA LIMHP LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12603 FOWLER AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-1996
Mailing Address - Country:US
Mailing Address - Phone:402-915-2251
Mailing Address - Fax:
Practice Address - Street 1:319 S 17TH ST STE 232
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68102-1926
Practice Address - Country:US
Practice Address - Phone:402-915-2251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE766101YA0400X
NE526101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE96065OtherBCBS