Provider Demographics
NPI:1104288711
Name:CAMPBELL, BRITTANY KRISTINE (LPC-LT)
Entity type:Individual
Prefix:MS
First Name:BRITTANY
Middle Name:KRISTINE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LPC-LT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 4TH STREET
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE DU SAC
Mailing Address - State:WI
Mailing Address - Zip Code:53578
Mailing Address - Country:US
Mailing Address - Phone:608-643-3663
Mailing Address - Fax:608-643-5014
Practice Address - Street 1:2300 N MAYFAIR RD
Practice Address - Street 2:SUITE 425
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226
Practice Address - Country:US
Practice Address - Phone:414-727-4455
Practice Address - Fax:414-727-4690
Is Sole Proprietor?:No
Enumeration Date:2016-03-23
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2321-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional