Provider Demographics
NPI:1871742247
Name:CAMPBELL, RICHARD NAUGLE (MS, LMHC)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:NAUGLE
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 DRAWDY WAY
Mailing Address - Street 2:
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-4323
Mailing Address - Country:US
Mailing Address - Phone:772-475-3899
Mailing Address - Fax:
Practice Address - Street 1:1903 S. 25TH STREET
Practice Address - Street 2:SUITE 201
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34947-4740
Practice Address - Country:US
Practice Address - Phone:772-460-1020
Practice Address - Fax:772-460-1024
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4813101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health