Basic Information
| Provider Information | |||||||||
| NPI: | 1588770663 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CAMPBELL | ||||||||
| FirstName: | SHERRY | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MA, NCC, LMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 33 LAKE AVE | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 140862608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166812836 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 46 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | HAMBURG | ||||||||
| State: | NY | ||||||||
| PostalCode: | 140754905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166464661 | ||||||||
| FaxNumber: | 7166464990 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 000312 | NY | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.