Healthcare Provider Details

I. General information

NPI: 1972923571
Provider Name (Legal Business Name): CATHRYN CAMPBELL LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2014
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1223 N PROVIDENCE RD
MEDIA PA
19063-1235
US

IV. Provider business mailing address

1223 N PROVIDENCE RD
MEDIA PA
19063-1235
US

V. Phone/Fax

Practice location:
  • Phone: 484-816-6181
  • Fax:
Mailing address:
  • Phone: 484-680-0681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW131474
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: