Individual
ANDREA SUE CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
429 N PENNSYLVANIA ST STE 111, INDIANAPOLIS, IN 46204-1873
(855) 284-7483
Mailing address
PO BOX 748465, ATLANTA, GA 30374-8465
(855) 284-7483
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
105921
CA
1041C0700X
Clinical Social Worker
124132
MA
1041C0700X
Clinical Social Worker
16894
LA
1041C0700X
Clinical Social Worker
Primary
34004864A
IN
1041C0700X
Clinical Social Worker
I.2103027
OH
1041C0700X
Clinical Social Worker
SW18247
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100270530
—
IN
Enumeration date
10/05/2006
Last updated
05/22/2023
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