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General NPI Number Information
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NPI Number | 1306638945
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Entity Type | Individual
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Provider Name | MICHAEL CAMPBELL MSW, LMSW
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Gender | Male
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Dates
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Enumeration Date | 05/20/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 660 S MOUNT JULIET RD STE 130
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City | MT JULIET
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State | TN
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Zip | 37122-6496
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Country | US
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Telephone | 865-588-3173
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Fax | 615-369-8697
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Provider Business Mailing Address
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Address Line | 3560 RIVEROAKS DR
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City | COOKEVILLE
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State | TN
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Zip | 38506-6405
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Country | US
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Telephone | 714-919-6709
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 15881
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License Number State | TN
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