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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295896603 | NPPES |
| North Carolina | Other | 2877013A | MEDICARE |
| North Carolina | MEDICAID | 6106584 | MEDICARE |
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