Healthcare Provider Details

I. General information

NPI: 1235076415
Provider Name (Legal Business Name): TERESA CAMPBELL COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

940 S PACIFIC ST
CAPE GIRARDEAU MO
63703-7841
US

IV. Provider business mailing address

2535 RANCHITO DR
CAPE GIRARDEAU MO
63701-3630
US

V. Phone/Fax

Practice location:
  • Phone: 573-270-1003
  • Fax: 573-270-1003
Mailing address:
  • Phone: 573-270-1003
  • Fax: 573-270-1003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TERESA ANN CAMPBELL
Title or Position: COUNSELOR
Credential: LPC
Phone: 573-270-1003