Healthcare Provider Details

I. General information

NPI: 1205426244
Provider Name (Legal Business Name): NOLAN J CAMPBELL LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2021
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9809 S FRANKLIN DR STE 302
FRANKLIN WI
53132-8885
US

IV. Provider business mailing address

505 S DEWEY ST STE 212A
EAU CLAIRE WI
54701-3781
US

V. Phone/Fax

Practice location:
  • Phone: 262-789-1191
  • Fax:
Mailing address:
  • Phone: 855-607-8242
  • Fax: 715-848-0425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10262
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number10262125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: