Provider Demographics
NPI:1912671371
Name:CAMPBELL, MELISA DAWN (LMHC, LADC)
Entity Type:Individual
Prefix:
First Name:MELISA
Middle Name:DAWN
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LMHC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8910 MAYNARD RD
Mailing Address - Street 2:
Mailing Address - City:PALO CEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:96073-9695
Mailing Address - Country:US
Mailing Address - Phone:530-630-8969
Mailing Address - Fax:
Practice Address - Street 1:8910 MAYNARD RD
Practice Address - Street 2:
Practice Address - City:PALO CEDRO
Practice Address - State:CA
Practice Address - Zip Code:96073-9695
Practice Address - Country:US
Practice Address - Phone:530-630-8969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-08
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)