Organization
NEW LIFE CHRISTIAN COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN MATTHEW CAMPBELL PH.D. (PRESIDENT)
(407) 322-6868
Entity
Organization
Contact information
Practice address
405 WAYMONT CT, STE. 111, LAKE MARY, FL 32746-3586
(407) 322-6868
(407) 322-6868
Mailing address
405 WAYMONT CT, STE. 111, LAKE MARY, FL 32746-3586
(407) 322-6868
(407) 322-6868
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY0004142
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005337111
AETNA PIN BRIAN CAMPBELL
FL
01
—
053111
VALUOPTIONS-BRIANCAMPBELL
FL
01
—
1093863466
NPI BRIAN M CAMPBELL
—
01
—
131134000
MAGELLAN - BRIAN CAMPBELL
FL
01
—
197423440
TRICARECHAMPUS
FL
01
—
73535
BLUE CROSS BLUE SHIELD
FL
Enumeration date
06/04/2006
Last updated
10/27/2010
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