Provider Demographics
NPI:1396990727
Name:CAMPBELL, FRANCES (M ED, LP)
Entity type:Individual
Prefix:MS
First Name:FRANCES
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:M ED, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 W 28TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-4732
Mailing Address - Country:US
Mailing Address - Phone:212-929-5691
Mailing Address - Fax:
Practice Address - Street 1:3 W 29TH ST
Practice Address - Street 2:FIFTH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-4504
Practice Address - Country:US
Practice Address - Phone:212-725-7850
Practice Address - Fax:212-689-3212
Is Sole Proprietor?:No
Enumeration Date:2008-11-26
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP67696102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00244720Medicaid
NYW02191Medicare PIN