Cheryl Deane Campbell
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Shelton, WA
NPI 1649673302 · NPPES record last updated Oct 8, 2014
Key facts
- NPI
- 1649673302
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- CP60416021 (WA)
- Practice address
- 100 SE Whitener Rd
Shelton, WA 98584-7747 - Phone
- (360) 426-1582
- NPI assigned
- Oct 8, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP60416021 | WA | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CP60416021 | WA | Yes |
Addresses
Primary practice location
100 SE Whitener Rd
Shelton, WA 98584-7747
Mailing address
100 SE Whitener Rd
Shelton, WA 98584-7747
Phone (360) 426-1582
NPI Registry JSON
{
"created_epoch": "1412726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412726400000",
"number": "1649673302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 SE WHITENER RD",
"city": "SHELTON",
"state": "WA",
"postal_code": "985847747",
"telephone_number": "360-426-1582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 SE WHITENER RD",
"city": "SHELTON",
"state": "WA",
"postal_code": "985847747",
"telephone_number": "360-426-1582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "CHERYL",
"middle_name": "DEANE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-08",
"last_updated": "2014-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": "CP60416021",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shelton, WA
- John Butler
- Natalie Caroline Callely
- Jess Calohan
- Ella Kathryn Cameron
- Brianna Josephine Campbell
- Lumen Francia Campos
- Nix Cannady
- Babynette W Caras
- Elizabeth A. Carder
- Career Quest LLP
All providers in Shelton, WA · Addiction (Substance Use Disorder) Counselor in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 8, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.