Healthcare Provider Details

I. General information

NPI: 1093032690
Provider Name (Legal Business Name): TADD CAMPBELL PH.D., PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19409 PLANTATION RD UNIT 4
REHOBOTH BEACH DE
19971-4493
US

IV. Provider business mailing address

19409 PLANTATION RD UNIT 4
REHOBOTH BEACH DE
19971-4493
US

V. Phone/Fax

Practice location:
  • Phone: 302-224-1400
  • Fax: 302-224-1402
Mailing address:
  • Phone: 302-224-1400
  • Fax: 302-224-1402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number35SI00465400
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberB1-0011565
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: