Individual
BRENDA CAMPBELL
Active
Individual
BRENDA CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
ASW68892
CA
1041C0700X
Clinical Social Worker
Primary
84769
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ91892Z
SANTA CRUZ COUNTY MEDICARE GRAOUP PTAN#
CA
Enumeration date
04/10/2007
Last updated
08/28/2018
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