Elizabeth McMillen Campbell

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

4393 Issued in MN

Practice address

6381 Osgood Ave N BLDG C
Stillwater, MN 55082-6118

Phone

(612) 217-4569

Fax

(651) 383-4544

NPI assigned

Dec 19, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wholehearted Healing LLC

  • Mental Health Counselor
  • Wayzata, MN
  • NPI 1255934196

  MN

  Medicare reassignment NPD

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

{
    "created_epoch": "1702944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1003684036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6381 OSGOOD AVE N BLDG C",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826118",
            "telephone_number": "612-217-4569",
            "fax_number": "651-383-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6381 OSGOOD AVE N BLDG C",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826118",
            "telephone_number": "612-217-4569",
            "fax_number": "651-383-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "ELIZABETH",
        "middle_name": "MCMILLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-19",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "4393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley John Bush, N.D.
• Rebecca Ann Bush, ND
• Ashley Bushman
• Buurtzorg USA
• Anna Lin Bzdok, AU.D.
• Carson Cannon, D.D.S.
• Lucas Richard Cannon, PHARMD
• Canvas Health, Inc.
• Canvas Health, Inc.
• Canvas Health, Inc.

• All providers in Stillwater, MN
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.