1659771491 NPI number — DORIAN CAMPBELL TEMPLE M.S., LCPC, MT-BC

Table of content: DORIAN CAMPBELL TEMPLE M.S., LCPC, MT-BC (NPI 1659771491)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659771491 NPI number — DORIAN CAMPBELL TEMPLE M.S., LCPC, MT-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CAMPBELL TEMPLE
Provider First Name:
DORIAN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.S., LCPC, MT-BC
Provider Gender Code:
F

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:
1659771491
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/24/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1003 W 7TH ST STE 500
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FREDERICK
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21701-8512
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-345-1022
Provider Business Mailing Address Fax Number:
301-560-5558

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
217 MARYLAND AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TANEYTOWN
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21787-2012
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-297-9422
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/29/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  LC14229 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com