Provider Demographics
NPI:1417744129
Name:CAMPBELL, SIDNIE (LPC)
Entity type:Individual
Prefix:
First Name:SIDNIE
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9659 N SAM HOUSTON PKWY E STE 150
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-1290
Mailing Address - Country:US
Mailing Address - Phone:346-298-1720
Mailing Address - Fax:
Practice Address - Street 1:9659 N SAM HOUSTON PKWY E STE 150
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-1290
Practice Address - Country:US
Practice Address - Phone:346-298-1720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX98140101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health