Individual
MRS. MYRA IRENE CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
28418 LOBO LN, CULDESAC, ID 83524-6173
(208) 553-6163
Mailing address
28418 LOBO LN, CULDESAC, ID 83524-6173
(208) 553-6163
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LAC-7239
ID
101YP2500X
Professional Counselor
Primary
LPC-7239
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000001
WA STATE LICENSE
WA
05
—
1396088282
—
ID
Enumeration date
03/29/2013
Last updated
06/08/2026
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