Individual provider Active NPI

Stephanie Manning Campbell

  • Professional Counselor
  • Yorktown, VA
National Provider Identifier
1003303629
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
3630 George Washington Mem Hwy Ste F1
Yorktown, VA 23693-3350
Phone
(757) 241-4407
Fax
(757) 782-4004
NPI assigned
Apr 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

3630 George Washington Mem Hwy Ste F1
Yorktown, VA 23693-3350

Mailing address

3630 George Washington Mem Hwy Ste F1
Yorktown, VA 23693-3350
Phone (757) 204-1866

Other practice location 1

1501 Kiln Creek Pkwy
Newport News, VA 23602-9665
Phone (757) 886-7961

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250402001474 VA Practitioner - Mental Health Counselor 0244753002 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jill M Nardin, LPC, PC Professional CurrentSince Jan 24, 2025 Accepting new patients

Locations

3630 George Washington Mem Hwy
Ste F1
Yorktown, VA 23693
Phone (757) 204-1866

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1003303629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 GEORGE WASHINGTON MEM HWY STE F1",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236933350",
            "telephone_number": "757-204-1866",
            "fax_number": "757-782-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 GEORGE WASHINGTON MEM HWY STE F1",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236933350",
            "telephone_number": "757-241-4407",
            "fax_number": "757-782-4004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Kiln Creek Pkwy",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236029665",
            "country_code": "US",
            "telephone_number": "757-886-7961",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "STEPHANIE",
        "middle_name": "MANNING",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-19",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorktown, VA

Sources for this page

Verify at the official NPI Registry.