Healthcare Provider Details

I. General information

NPI: 1477555332
Provider Name (Legal Business Name): JUDITH P CAMPBELL LPC, LMFT, LSATP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 04/28/2023
Certification Date: 03/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 SWEET HILLS DR
AMHERST VA
24521-3284
US

IV. Provider business mailing address

PO BOX 128
MONROE VA
24574-0128
US

V. Phone/Fax

Practice location:
  • Phone: 434-929-0355
  • Fax: 434-929-0357
Mailing address:
  • Phone: 434-942-6369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701002485
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: