Healthcare Provider Details

I. General information

NPI: 1568546448
Provider Name (Legal Business Name): ELIZABETH D CAMPBELL LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH ANN DICKERSON

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

586 RIVER OAKS DR
MILFORD MI
48381-1039
US

IV. Provider business mailing address

586 RIVER OAKS DR
MILFORD MI
48381-1039
US

V. Phone/Fax

Practice location:
  • Phone: 865-274-7672
  • Fax:
Mailing address:
  • Phone: 865-274-7672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: