MEDICARE: GRACE E CAMPBELL LMFTA

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	106H00000X	Marriage & Family Therapist	10298A	NC

General Provider Information

NPI Number	:	1457055857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACE E CAMPBELL LMFTA

Provider Business Mailing Address
First Line	:	301 EVANS ST STE 302
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27858-1831
Country	:	US
Telephone Number	:	434-546-2214
Fax Number	:

Provider Business Practice Location Address
First Line	:	140 SCHOOL DR
Second Line	:
City	:	SNOW HILL
State	:	NC
Zip	:	28580-7288
Country	:	US
Telephone Number	:	252-747-8162
Fax Number	:	252-747-8163

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

Provider Enumeration Date	:	03/29/2023
Last Update Date	:	06/15/2026

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Directions to “ GRACE E CAMPBELL LMFTA” Practice Location

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