Provider Demographics
NPI:1285799676
Name:CAMPBELL, LORRIE CORETTE (LCPC)
Entity type:Individual
Prefix:
First Name:LORRIE
Middle Name:CORETTE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 W MERCURY ST
Mailing Address - Street 2:SUITE 207B
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-1659
Mailing Address - Country:US
Mailing Address - Phone:406-782-0114
Mailing Address - Fax:406-723-5345
Practice Address - Street 1:305 W MERCURY ST
Practice Address - Street 2:SUITE 207B
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-1659
Practice Address - Country:US
Practice Address - Phone:406-782-0114
Practice Address - Fax:406-723-5345
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT782LCPC101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional