Basic Information
| Provider Information | |||||||||
| NPI: | 1750685483 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CAMPBELL | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | |||||||||
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| Credential: | MA, LMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 721 N PINES RD STE 102 | ||||||||
| Address2: | |||||||||
| City: | SPOKANE VALLEY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992065225 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5098921100 | ||||||||
| FaxNumber: | 5099227947 | ||||||||
| Practice Location | |||||||||
| Address1: | 721 N PINES RD STE 102 | ||||||||
| Address2: | |||||||||
| City: | SPOKANE VALLEY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992065225 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5099995535 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2011 | ||||||||
| LastUpdateDate: | 06/08/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | LH 00011161 | WA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.