Healthcare Provider Details

I. General information

NPI: 1780503144
Provider Name (Legal Business Name): JEWEL LEONESLIE CAMPBELL I
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11516 LOCKWOOD DR APT C1
SILVER SPRING MD
20904-2415
US

IV. Provider business mailing address

11516 LOCKWOOD DR APT C1
SILVER SPRING MD
20904-2415
US

V. Phone/Fax

Practice location:
  • Phone: 301-408-8307
  • Fax:
Mailing address:
  • Phone: 301-408-8307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: