MEDICARE: JANET CAMPBELL MSW CCSW INC

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	251S00000X	Community/Behavioral Health Agency	C000135	NC

General Provider Information

NPI Number	:	1699941526
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JANET CAMPBELL MSW CCSW INC

Provider Business Mailing Address
First Line	:	3921 SUNSET RIDGE ROAD
Second Line	:	SUITE 303
City	:	RALEIGH
State	:	NC
Zip	:	27607-6681
Country	:	US
Telephone Number	:	919-782-2933
Fax Number	:	919-782-0906

Provider Business Practice Location Address
First Line	:	3921 SUNSET RIDGE RD.
Second Line	:	SUITE 303
City	:	RALEIGH
State	:	NC
Zip	:	27607-6681
Country	:	US
Telephone Number	:	919-782-2933
Fax Number	:	919-782-0906

Authorized Official
Title or Position	:	CLINICAL SOCIAL WORKER
Name	:	MS. JANET MARLENE CAMPBELL
Credential	:	LCSW
Telephone Number	:	919-782-2933

Provider Enumeration Date	:	04/30/2008
Last Update Date	:	08/18/2009

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