Provider Demographics
NPI:1871729103
Name:CAMPBELL, GAYLA JEAN (LPC-S, PHD)
Entity type:Individual
Prefix:DR
First Name:GAYLA
Middle Name:JEAN
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LPC-S, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 64184
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79464-4184
Mailing Address - Country:US
Mailing Address - Phone:806-793-5770
Mailing Address - Fax:806-793-5771
Practice Address - Street 1:1700 COGDELL BLVD
Practice Address - Street 2:
Practice Address - City:SNYDER
Practice Address - State:TX
Practice Address - Zip Code:79549-6162
Practice Address - Country:US
Practice Address - Phone:325-574-7247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-01
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18560101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional