Marilyn Campbell-Muck, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH8329 Issued in FL

Practice address

1600 Sarno Rd
Suite 119J
Melbourne, FL 32935-4938

Phone

(321) 243-0262

NPI assigned

Jan 10, 2013

Last updated

Jan 10, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Marilyn Waite Fackler Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1357776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1023355039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SARNO RD",
            "address_2": "SUITE 119J",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329354938",
            "telephone_number": "321-243-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SARNO RD",
            "address_2": "SUITE 119J",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329354938",
            "telephone_number": "321-243-0262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL-MUCK",
        "first_name": "MARILYN",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-10",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH8329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARILYN",
            "last_name": "FACKLER",
            "middle_name": "WAITE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jamica Cambridge
• Camellia a Westwell Psy D PA
• Sarah Elizabeth Camp
• Tina M Campanile, PAC
• Campbell Therapy Services, Inc.
• Amanda Campbell, D.C.
• Briana Campbell, RBT
• Daniel J Campbell, DO
• Hope N Campbell, BEHAVIOR TECHNICIAN
• Kevin Ray Campbell, M.D.

• Mental Health Counselor in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.