Provider Demographics
NPI:1477438372
Name:CAMPBELL, IRMA
Entity type:Individual
Prefix:DR
First Name:IRMA
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 JORALEMON ST FL 2
Mailing Address - Street 2:IRMACAMPBELL01@GMAIL.COM
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201
Mailing Address - Country:US
Mailing Address - Phone:917-200-3331
Mailing Address - Fax:516-630-3574
Practice Address - Street 1:142 JORALEMON ST FL 2
Practice Address - Street 2:IRMACAMPBELL01@GMAIL.COM
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201
Practice Address - Country:US
Practice Address - Phone:917-200-3331
Practice Address - Fax:516-630-3574
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
NY027441103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty