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NPI Code Detail

MEDICARE: KALLEN CAMPBELL LCSW

MEDICARE: KALLEN CAMPBELL LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker0904020446VA

General Provider Information

NPI Number : 1104389808
Entity Type Code : Individual
Provider Name (Legal Business Name) : KALLEN CAMPBELL LCSW
Provider Business Mailing Address
First Line : 2800 EISENHOWER AVE STE 200
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22314-5210
Country : US
Telephone Number : 703-562-9220
Fax Number :
Provider Business Practice Location Address
First Line : 2800 EISENHOWER AVE STE 200
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22314-5210
Country : US
Telephone Number : 703-562-9220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2019
Last Update Date : 05/26/2026

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Directions to “ KALLEN CAMPBELL LCSW” Practice Location

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