Healthcare Provider Details

I. General information

NPI: 1801993431
Provider Name (Legal Business Name): MARIA LINDA CAMPO LCSW, ACSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

528 RIDGE RD
SPRING CITY PA
19475-9681
US

IV. Provider business mailing address

528 RIDGE RD
SPRING CITY PA
19475-9681
US

V. Phone/Fax

Practice location:
  • Phone: 610-495-6026
  • Fax: 610-495-1482
Mailing address:
  • Phone: 610-495-6026
  • Fax: 610-495-1482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW012900
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier112411
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerVALUE OPTIONS
# 2
Identifier001655873
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerHIGH MARK (FEP)
# 3
Identifier137026000
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerMAGELLAN
# 4
Identifier226530560
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerUNITED BEHAVIORAL HEALTH
# 5
Identifier2318551000
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerBLUE CROSS
# 6
Identifier7303222
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerAETNA
# 7
Identifier2318551000
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerAMERIHEALTH
# 8
Identifier325151
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerMENTAL HEALTH NETWORK
# 9
Identifier001664582
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerPERSONAL CHOICE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: