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NPI 1124915228

NPI 1124915228 : CAMPBELL PSYCHOTHERAPY, LLC : PHILADELPHIA, PA

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General NPI Number Information
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    NPI Number           |    1124915228
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    Entity Type          |    Organization 
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    Legal Business Name  |    CAMPBELL PSYCHOTHERAPY, LLC 
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Dates
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    Enumeration Date     |    06/20/2025
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    Last Update Date     |    06/20/2025
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Provider Practice Location Address
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    Address Line         |    801 S 47TH ST APT 302 
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    City                 |    PHILADELPHIA
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    State                |    PA
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    Zip                  |    19143-3652
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    Country              |    US
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    Telephone            |    215-484-3987
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    700 S 7TH STREET #366
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    City                 |    PHILADELPHIA
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    State                |    PA
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    Zip                  |    19147
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    Country              |    US
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    Telephone            |    215-484-3987
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     KATELYN  CAMPBELL 
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    Credential           |    LCSW
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    Telephone            |    215-484-3987
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251S00000X
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    Taxonomy Name        |    Community/Behavioral Health Agency
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    License Number       |    
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    License Number State |    
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