Provider Demographics
NPI:1700543097
Name:ALLYSON CAMPBELL, LCSW, LMHP, LLC
Entity type:Organization
Organization Name:ALLYSON CAMPBELL, LCSW, LMHP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ALLYSON
Authorized Official - Middle Name:MAREE
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:LMHP, LCSW
Authorized Official - Phone:870-706-9855
Mailing Address - Street 1:1330 S 166TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-1324
Mailing Address - Country:US
Mailing Address - Phone:870-706-9855
Mailing Address - Fax:
Practice Address - Street 1:18025 OAK STREET SUITE A
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-1324
Practice Address - Country:US
Practice Address - Phone:402-671-0889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-21
Last Update Date:2022-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty