Provider Demographics
NPI:1588770663
Name:CAMPBELL, SHERRY LEE (MA, NCC, LMHC)
Entity type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:LEE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MA, NCC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:NY
Mailing Address - Zip Code:14086-2608
Mailing Address - Country:US
Mailing Address - Phone:716-681-2836
Mailing Address - Fax:
Practice Address - Street 1:46 MAIN ST
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-4905
Practice Address - Country:US
Practice Address - Phone:716-646-4661
Practice Address - Fax:716-646-4990
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000312101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health