Provider Demographics
NPI:1982937991
Name:CAMPBELL, PATRICIA M (LPC, LCADC, CCS,ACS)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:M
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LPC, LCADC, CCS,ACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:899 BAYSHORE ROAD
Mailing Address - Street 2:
Mailing Address - City:VILLAS
Mailing Address - State:NJ
Mailing Address - Zip Code:08251
Mailing Address - Country:US
Mailing Address - Phone:609-886-8666
Mailing Address - Fax:609-886-9666
Practice Address - Street 1:899 BAYSHORE RD
Practice Address - Street 2:
Practice Address - City:VILLAS
Practice Address - State:NJ
Practice Address - Zip Code:08251-2780
Practice Address - Country:US
Practice Address - Phone:609-886-8666
Practice Address - Fax:609-886-9666
Is Sole Proprietor?:No
Enumeration Date:2009-09-09
Last Update Date:2017-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00053400101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor