MEDICARE: DAKOTA MARIE CAMPBELL LGPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	LGP17462	MD

General Provider Information

NPI Number	:	1053279133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAKOTA MARIE CAMPBELL LGPC

Provider Business Mailing Address
First Line	:	10630 LITTLE PATUXENT PKWY STE 209
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-6278
Country	:	US
Telephone Number	:	410-740-8066
Fax Number	:

Provider Business Practice Location Address
First Line	:	10630 LITTLE PATUXENT PKWY STE 209
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-6278
Country	:	US
Telephone Number	:	410-740-8066
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

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