Provider Demographics
NPI:1215267893
Name:CAMPBELL, CYDNEY DIANE (MA, LMHC, NCC)
Entity type:Individual
Prefix:
First Name:CYDNEY
Middle Name:DIANE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MA, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4995 ARROYO CHAMISA RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-3719
Mailing Address - Country:US
Mailing Address - Phone:505-271-6465
Mailing Address - Fax:505-271-6465
Practice Address - Street 1:7001 PROSPECT PL NE
Practice Address - Street 2:SUITE A
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4311
Practice Address - Country:US
Practice Address - Phone:505-823-4530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0082521101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health