Individual provider Active NPI

Robert Loy Campbell Jr., LCSW

  • Clinical Social Worker
  • Leesburg, FL
National Provider Identifier
1023059714
Registry record updated May 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 9446 Issued in FL
Practice address
711 W Main St
Leesburg, FL 34748-5128
Phone
(352) 435-4000
Fax
(352) 435-4015
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW 9446 FL Primary

Addresses

Primary practice location

711 W Main St
Leesburg, FL 34748-5128

Mailing address

711 W Main St
Leesburg, FL 34748-5128
Phone (352) 435-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20150922000904 FL Practitioner - Clinical Social Worker 6800103938 Practice locations: Wildwood, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

601 Webster St
Wildwood, FL 34785-3828
Phone (352) 350-5552

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW 9446FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Neuropsychology & Counseling Services PA CurrentSince Jul 15, 2015 Accepting new patients

Locations

101 E Maud St
Tavares, FL 32778
Phone (352) 253-9348

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243468800000",
    "number": "1023059714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 W MAIN ST",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485128",
            "telephone_number": "352-435-4000",
            "fax_number": "352-435-4015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 W MAIN ST",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485128",
            "telephone_number": "352-435-4000",
            "fax_number": "352-435-4015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "ROBERT",
        "middle_name": "LOY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2009-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 9446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.