Active NPI
Bevin Jane Campbell, PSY.D.
- Clinical Psychologist
- Brooklyn, NY
National Provider Identifier
1043564925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 019731
- Practice address
- 26 Court Street
Brooklyn, NY 11201 - Phone
- (347) 699-2920
- NPI assigned
- Oct 31, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 019731 | NY | Primary |
Addresses
Primary practice location
26 Court Street
Brooklyn, NY 11201
Mailing address
26 Court Street
Brooklyn, NY 11242
Phone (347) 699-2920
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 21, 2023 through Jun 21, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384905600000",
"number": "1043564925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26 COURT STREET",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11242",
"telephone_number": "347-699-2920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26 COURT STREET",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11201",
"telephone_number": "347-699-2920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "BEVIN",
"middle_name": "JANE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-31",
"last_updated": "2013-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "019731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.