Provider Demographics
NPI:1215273776
Name:CAMPBELL, MEGHAN REBECCA (MSW)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:REBECCA
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-4006
Mailing Address - Country:US
Mailing Address - Phone:508-226-6031
Mailing Address - Fax:508-223-4128
Practice Address - Street 1:200 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-4006
Practice Address - Country:US
Practice Address - Phone:508-226-6031
Practice Address - Fax:508-223-4128
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-02
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness