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General NPI Number Information
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NPI Number | 1487011391
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Entity Type | Individual
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Provider Name | CHANA DANIELLE CAMPBELL MA, MPHIL, LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 01/22/2016
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Last Update Date | 10/19/2019
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Provider Practice Location Address
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Address Line | 2330 SCENIC HWY S
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City | SNELLVILLE
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State | GA
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Zip | 30078-3115
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Country | US
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Telephone | 678-856-1770
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Fax |
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Provider Business Mailing Address
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Address Line | 3237 PATE CREEK VW
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City | SNELLVILLE
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State | GA
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Zip | 30078-5019
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Country | US
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Telephone | 770-978-0368
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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