1568196582 NPI number — WM. CAMPBELL COUNSELING, PLLC

Table of content: (NPI 1568196582)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568196582 NPI number — WM. CAMPBELL COUNSELING, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WM. CAMPBELL COUNSELING, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568196582
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/14/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5200 W RIVER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MT PLEASANT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48858-8207
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-387-8358
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 W MICHIGAN ST STE 7
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNT PLEASANT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48858-2410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-387-8358
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/14/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CAMPBELL
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
HOWARD
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
989-387-8358

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)