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General NPI Number Information
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NPI Number | 1568889681
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Entity Type | Individual
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Provider Name | JESSICA LETISHA CAMPBELL LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/26/2014
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 211 E SIX FORKS RD STE 117
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City | RALEIGH
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State | NC
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Zip | 27609-7753
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Country | US
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Telephone | 919-833-8899
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Fax | 833-449-5209
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Provider Business Mailing Address
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Address Line | 2664 TIMBER DR STE 194
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City | GARNER
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State | NC
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Zip | 27529-2571
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Country | US
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Telephone | 919-218-0375
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P008556
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C013911
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License Number State | NC
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