Individual provider Active NPI

Susan Colwell Campion, LMFT LADC

  • Marriage & Family Therapist
  • New Haven, CT
National Provider Identifier
1053514398
Registry record updated Sep 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
000752 Issued in CT
Practice address
82 Morris Cove Rd
New Haven, CT 06512-4017
Phone
(203) 494-8148
Fax
(203) 468-2139
NPI assigned
Jun 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 000752 CT Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 000369 CT

Addresses

Primary practice location

82 Morris Cove Rd
New Haven, CT 06512-4017

Mailing address

82 Morris Cove Rd
New Haven, CT 06512-4017
Phone (203) 494-8148

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
000369CTMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1053514398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 MORRIS COVE RD",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065124017",
            "telephone_number": "203-494-8148",
            "fax_number": "203-468-2139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 MORRIS COVE RD",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065124017",
            "telephone_number": "203-494-8148",
            "fax_number": "203-468-2139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPION",
        "first_name": "SUSAN",
        "middle_name": "COLWELL",
        "name_prefix": "Ms.",
        "credential": "LMFT LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "000752",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "000369",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; 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.