Shaneka Alexandria Campbell, LCMFT

Individual provider Active NPI Marriage & Family Therapist · Columbia, MD

NPI 1194474346 · NPPES record last updated Jul 19, 2024

Key facts

NPI
1194474346
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
LCM1037 (MD)
Practice address
10630 Little Patuxent Pkwy
Columbia, MD 21044-3264
Phone
(860) 752-5162
NPI assigned
Mar 23, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LCM1037MDMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Milestones Counseling and Consulting Services Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LCM1037 MD Yes

Addresses

Primary practice location

10630 Little Patuxent Pkwy
Columbia, MD 21044-3264

Mailing address

3403 Hampton Hollow Dr Apt K
Silver Spring, MD 20904-6133
Phone (860) 752-5162

Other practice location 1

3403 Hampton Hollow Dr Apt K
Silver Spring, MD 20904-6133
Phone (860) 752-5162

Other providers in Columbia, MD

All providers in Columbia, MD · Marriage & Family Therapist in Maryland

Sources for this page

Verify at the official NPI Registry.