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NPI Code Detail

MEDICARE: MR. BRENTON CAMPBELL LPC

MEDICARE: MR. BRENTON 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
1101YP2500XProfessional Counselor0701005199VA

General Provider Information

NPI Number : 1730455940
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRENTON CAMPBELL LPC
Provider Business Mailing Address
First Line : 463 E WASHINGTON ST
Second Line :
City : HARRISONBURG
State : VA
Zip : 22802-4853
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 463 E WASHINGTON ST
Second Line :
City : HARRISONBURG
State : VA
Zip : 22802-4853
Country : US
Telephone Number : 540-433-3100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2012
Last Update Date : 04/02/2012

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