Provider Demographics
NPI:1063927952
Name:CAMPBELL, MARCI (CMHC)
Entity type:Individual
Prefix:
First Name:MARCI
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:889 S DAVIS BLVD
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-2011
Mailing Address - Country:US
Mailing Address - Phone:801-318-6303
Mailing Address - Fax:
Practice Address - Street 1:1760 W 4805 S
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84129-1177
Practice Address - Country:US
Practice Address - Phone:801-955-9110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-13
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5479671-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health