MEDICARE: THOMAS A CAMPBELL

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	252400000X	NV

General Provider Information

NPI Number	:	1497007645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS A CAMPBELL

Provider Business Mailing Address
First Line	:	6130 W TROPICANA AVE
Second Line	:	198
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-4604
Country	:	US
Telephone Number	:	702-205-3661
Fax Number	:

Provider Business Practice Location Address
First Line	:	6130 W TROPICANA AVE
Second Line	:	198
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-4604
Country	:	US
Telephone Number	:	702-205-3661
Fax Number	:

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

Provider Enumeration Date	:	10/12/2012
Last Update Date	:	10/12/2012

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Directions to “ THOMAS A CAMPBELL ” Practice Location

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