MEDICARE: KATHERINE C CAMPBELL LPC

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
1	101YM0800X	Mental Health Counselor	0704016570	VA

General Provider Information

NPI Number	:	1285500355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE C CAMPBELL LPC

Provider Business Mailing Address
First Line	:	806 CAMEO DR
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23666-5914
Country	:	US
Telephone Number	:	718-475-8991
Fax Number	:	757-209-5730

Provider Business Practice Location Address
First Line	:	1702 TODDS LN STE 260
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23666-3198
Country	:	US
Telephone Number	:	757-930-6329
Fax Number	:	757-930-6329

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/15/2025
Last Update Date	:	05/01/2026

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