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General NPI Number Information
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NPI Number | 1780120584
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Entity Type | Organization
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Legal Business Name | MEGAN J. CAMPBELL, ART THERAPY INC.
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Dates
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Enumeration Date | 01/17/2017
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Last Update Date | 01/17/2017
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Provider Practice Location Address
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Address Line | 750 ALMAR PKWY SUITE 205
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City | BOURBONNAIS
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State | IL
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Zip | 60914-2315
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Country | US
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Telephone | 815-214-9754
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Fax |
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Provider Business Mailing Address
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Address Line | 750 ALMAR PKWY SUITE 205
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City | BOURBONNAIS
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State | IL
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Zip | 60914-2315
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Country | US
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Telephone | 815-214-9754
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Fax |
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Authorized Official
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Title or Position | CLINICAL COUNSELOR
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Name | MEGAN J CAMPBELL
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Credential | LCPC, ATR
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Telephone | 815-214-9754
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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 | 180.009612
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License Number State | IL
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