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NPI Code Detail

MEDICARE: ABBY CAMPBELL LCSW, MSW

MEDICARE: ABBY CAMPBELL LCSW, MSW
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
11041C0700XClinical Social Worker149.017119IL

General Provider Information

NPI Number : 1891146627
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABBY CAMPBELL LCSW, MSW
Provider Business Mailing Address
First Line : 149 S EDGELAWN DR
Second Line :
City : AURORA
State : IL
Zip : 60506-4509
Country : US
Telephone Number : 815-488-9727
Fax Number :
Provider Business Practice Location Address
First Line : 64 MAIN ST
Second Line :
City : OSWEGO
State : IL
Zip : 60543-9893
Country : US
Telephone Number : 630-519-1010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2016
Last Update Date : 08/28/2023

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