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General NPI Number Information
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NPI Number | 1891535274
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Entity Type | Organization
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Legal Business Name | ALEXIS CAMPBELL LPC
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Dates
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Enumeration Date | 05/31/2024
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Last Update Date | 05/31/2024
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Provider Practice Location Address
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Address Line | 55 THOMPSON ST APT 6E
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City | EAST HAVEN
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State | CT
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Zip | 06513-1936
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Country | US
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Telephone | 203-584-7339
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Fax |
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Provider Business Mailing Address
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Address Line | 55 THOMPSON ST APT 6E
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City | EAST HAVEN
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State | CT
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Zip | 06513-1936
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LPC
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Name | ALEXIS CAMPBELL
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Credential | LPC
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Telephone | 203-584-7339
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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 |
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License Number State |
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