Provider Demographics
NPI:1144554494
Name:CAMPBELL, SARAH ELIZABETH (PHD, LPC, NCC)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ELIZABETH
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:PHD, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 358
Mailing Address - Street 2:
Mailing Address - City:SHIP BOTTOM
Mailing Address - State:NJ
Mailing Address - Zip Code:08008-0247
Mailing Address - Country:US
Mailing Address - Phone:609-607-7920
Mailing Address - Fax:
Practice Address - Street 1:256 W 9TH ST # E
Practice Address - Street 2:
Practice Address - City:SHIP BOTTOM
Practice Address - State:NJ
Practice Address - Zip Code:08008-4611
Practice Address - Country:US
Practice Address - Phone:609-607-7920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-18
Last Update Date:2017-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
NJ37PC00599000101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health