Campbell, Timothy W

Campbell, Timothy W is an individual health care provider with primary practice located at 200 Tarpon Trl , Jacksonville NC 28546-5287. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Campbell, Timothy W can be contacted via phone (910) 938-1114.

Contact Information

Primary practice address
200 Tarpon Trl Jacksonville NC 28546-5287
Phone: (910) 938-1114
Fax: (910) 938-1118
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X C000480 North Carolina

Profile Details

NPI number 1295896603
LBN Legal business name Campbell, Timothy W
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2006
Last updated Apr 4th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295896603 NPPES
North Carolina Other 2877013A MEDICARE
North Carolina MEDICAID 6106584 MEDICARE

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