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NPI Code Detail

MEDICARE: MS. LISA CLAIRE CAMPBELL ATR,PCC-S

MEDICARE: MS. LISA CLAIRE CAMPBELL ATR,PCC-S
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 CounselorE1100045OH

General Provider Information

NPI Number : 1881002913
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LISA CLAIRE CAMPBELL ATR,PCC-S
Provider Business Mailing Address
First Line : 23293 COMMERCE PARK
Second Line :
City : BEACHWOOD
State : OH
Zip : 44122-5808
Country : US
Telephone Number : 216-292-7170
Fax Number :
Provider Business Practice Location Address
First Line : 23293 COMMERCE PARK
Second Line :
City : BEACHWOOD
State : OH
Zip : 44122-5808
Country : US
Telephone Number : 216-292-7170
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2014
Last Update Date : 08/01/2014

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