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General NPI Number Information
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NPI Number | 1023641263
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Entity Type | Organization
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Legal Business Name | CAMPBELL COMPREHENSIVE PSYCHOLOGICAL SERVICES, LLC
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Dates
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Enumeration Date | 02/17/2020
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Last Update Date | 04/15/2020
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Provider Practice Location Address
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Address Line | 1985 W 33RD ST
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City | EDMOND
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State | OK
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Zip | 73013-3875
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Country | US
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Telephone | 405-482-3116
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Fax | 405-285-6814
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Provider Business Mailing Address
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Address Line | 2716 GREEN CANYON DR
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City | EDMOND
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State | OK
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Zip | 73013-5732
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Country | US
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Telephone | 405-482-3116
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Fax | 405-242-3892
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHRISTOPHER CAMPBELL
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Credential | PH.D.
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Telephone | 405-482-3116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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