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General NPI Number Information
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NPI Number | 1043984040
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Entity Type | Individual
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Provider Name | SHAROLYN R CAMPBELL
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Gender | Female
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Dates
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Enumeration Date | 08/03/2021
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Last Update Date | 12/29/2022
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Provider Practice Location Address
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Address Line | 310 SOUTH MLK JR STREET 310 MLK JR STREET
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City | ROWLAND
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State | NC
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Zip | 28383-2838
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Country | US
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Telephone | 191-028-0545
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 493
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City | ROWLAND
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State | NC
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Zip | 28383-0493
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Country | US
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Telephone | 191-028-0545
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 27301
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCAS27301
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCAS-A27301
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License Number State | NC
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