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General NPI Number Information
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NPI Number | 1962374991
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Entity Type | Organization
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Legal Business Name | MADELEINE CAMPBELL LCSW PLLC
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Dates
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Enumeration Date | 09/19/2025
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 2160 46TH ST
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City | ASTORIA
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State | NY
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Zip | 11105-1334
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Country | US
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Telephone | 516-847-4438
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Fax |
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Provider Business Mailing Address
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Address Line | 4470 21ST ST # 3156
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City | LONG ISLAND CITY
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State | NY
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Zip | 11101-5114
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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 | OWNER, PSYCHOTHERAPIST
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Name | MADELEINE ROSE CAMPBELL TRUJILLO
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Credential | LCSW
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Telephone | 347-224-5214
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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 |
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License Number State |
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