Healthcare Provider Details

I. General information

NPI: 1386280865
Provider Name (Legal Business Name): LINDA K CAMPBELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2019
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2960 N CIRCLE DR STE 200
COLORADO SPRINGS CO
80909-1163
US

IV. Provider business mailing address

1723 E SOUTHLAKE BLVD STE 120
SOUTHLAKE TX
76092-6445
US

V. Phone/Fax

Practice location:
  • Phone: 719-634-8891
  • Fax: 719-634-1897
Mailing address:
  • Phone: 817-437-4505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number79719
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.1689230
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0018282
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number14292
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: