Provider Demographics
NPI:1841068582
Name:CAMPBELL, KWASHIA (LCSW)
Entity type:Individual
Prefix:
First Name:KWASHIA
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11535 PEARSALL RD
Mailing Address - Street 2:
Mailing Address - City:ATASCOSA
Mailing Address - State:TX
Mailing Address - Zip Code:78002-5150
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11535 PEARSALL RD
Practice Address - Street 2:
Practice Address - City:ATASCOSA
Practice Address - State:TX
Practice Address - Zip Code:78002-5150
Practice Address - Country:US
Practice Address - Phone:210-622-4430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty