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General NPI Number Information
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NPI Number | 1417165689
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Entity Type | Individual
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Provider Name | NANCY MILLER CAMPBELL LPC
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Gender | Female
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Dates
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Enumeration Date | 05/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4411 SHARON RD
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City | CHARLOTTE
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State | NC
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Zip | 28211-3520
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Country | US
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Telephone | 704-366-9166
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Fax |
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Provider Business Mailing Address
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Address Line | 3935 WELL RD
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City | CHARLOTTE
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State | NC
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Zip | 28227-9107
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Country | US
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Telephone | 704-545-0132
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2916
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License Number State | NC
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