Campbell, Lori K

Campbell, Lori K is an sole proprietor health care provider with primary practice located at 3925 E Hagan St, Ste 102 , Bloomington IN 47401-8649. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Campbell, Lori K can be contacted via phone (812) 336-1994.

Contact Information

Primary practice address
3925 E Hagan St, Ste 102 Bloomington IN 47401-8649
Phone: (812) 336-1994
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 20041374A Indiana

Profile Details

NPI number 1427455179
LBN Legal business name Campbell, Lori K
Credentials PH.D., HSPP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 24th, 2014
Last updated Apr 14th, 2015 - about 11 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 1427455179 NPPES
Indiana MEDICAID 201267940 A

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