Individual provider Active NPI

Cassie Michelle Campbell, LPCC

  • Mental Health Counselor
  • San Diego, CA
National Provider Identifier
1023677978
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
7212 Issued in CA
Practice address
415 Laurel St # 3113
San Diego, CA 92101-1605
Phone
(951) 531-3367
NPI assigned
Jun 12, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 7212 CA Primary
Mental Health Counselor 101YM0800X 73146 TX

Addresses

Primary practice location

415 Laurel St # 3113
San Diego, CA 92101-1605

Mailing address

236 Providence Farm Dr
Boiling Springs, SC 29316-7469
Phone (951) 531-3367

Other practice location 1

3801 N Capital Of Texas Hwy Ste E240
Austin, TX 78746-1482
Phone (951) 531-3367

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250321003229 CA Practitioner - Mental Health Counselor 8224550983

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

236 Providence Farm Dr
Boiling Springs, SC 29316-7469

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
73146TXMDMental Health Counselor
7212CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sud Specialty Group - Ca CurrentSince Feb 12, 2025 Accepting new patients
Empower Mental Wellness Mental Health Current Accepting new patients

Locations

415 Laurel St
#3113
San Diego, CA 92101
Phone (951) 531-3367

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

3801 N Capital of Texas Hwy
Ste E240
Austin, TX 78746
Phone (512) 967-6783

Organizations & group practices 2

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": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1023677978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 PROVIDENCE FARM DR",
            "city": "BOILING SPRINGS",
            "state": "SC",
            "postal_code": "293167469",
            "telephone_number": "951-531-3367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 LAUREL ST # 3113",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921011605",
            "telephone_number": "951-531-3367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3801 N Capital Of Texas Hwy Ste E240",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787461482",
            "country_code": "US",
            "telephone_number": "951-531-3367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "CASSIE",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "7212",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "73146",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.