Healthcare Provider Details

I. General information

NPI: 1750482626
Provider Name (Legal Business Name): JAMES FRANCIS CAMPBELL PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

765 ALLENS AVE
PROVIDENCE RI
02905-5443
US

IV. Provider business mailing address

31 CAITLIN CT
KINGSTON RI
02881-1841
US

V. Phone/Fax

Practice location:
  • Phone: 401-490-8900
  • Fax: 401-490-2619
Mailing address:
  • Phone: 401-874-2288
  • Fax: 401-874-5010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number4696
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: