Provider Demographics
NPI:1336952019
Name:CAMPBELL, CHELSEA (BSW, CADC, CHW)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:BSW, CADC, CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47085 ROSA CT
Mailing Address - Street 2:
Mailing Address - City:NEW BALTIMORE
Mailing Address - State:MI
Mailing Address - Zip Code:48047-2915
Mailing Address - Country:US
Mailing Address - Phone:586-554-0795
Mailing Address - Fax:
Practice Address - Street 1:43800 GARFIELD RD
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-1136
Practice Address - Country:US
Practice Address - Phone:586-438-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker