Provider Demographics
NPI:1154029254
Name:CAMPBELL, ALEXANDRIA
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ALABAMA AGRICULTURAL & MECHANICAL UNIVERSITY
Mailing Address - Street 2:BHWTP2 GRADUATE SOCIAL WORK 104 BUCHANAN HALL
Mailing Address - City:NORMAL
Mailing Address - State:AL
Mailing Address - Zip Code:35762
Mailing Address - Country:US
Mailing Address - Phone:901-265-2214
Mailing Address - Fax:
Practice Address - Street 1:ALABAMA AGRICULTURAL & MECHANICAL UNIVERSITY
Practice Address - Street 2:BHWTP2 GRADUATE SOCIAL WORK 104 BUCHANAN HALL
Practice Address - City:NORMAL
Practice Address - State:AL
Practice Address - Zip Code:35762
Practice Address - Country:US
Practice Address - Phone:901-265-2214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health