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NPI Code Detail

MEDICARE: MS. YVONNE CAMPBELL LCSW

MEDICARE: MS. YVONNE CAMPBELL LCSW
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
11041C0700XClinical Social Worker0904002644VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295843902
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. YVONNE CAMPBELL LCSW
Provider Business Mailing Address
First Line : 4191 INNSLAKE DR STE 211
Second Line :
City : GLEN ALLEN
State : VA
Zip : 23060-3324
Country : US
Telephone Number : 804-303-9622
Fax Number : 47-164-3188
Provider Business Practice Location Address
First Line : 4191 INNSLAKE DR STE 211
Second Line :
City : GLEN ALLEN
State : VA
Zip : 23060-3324
Country : US
Telephone Number : 804-303-9622
Fax Number : 804-716-4318
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2006
Last Update Date : 08/27/2024

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