Active NPI
Geneele Crump-Campagnoli, LCSW
- Mental Health Counselor
- Elkhart, IN
National Provider Identifier
1063445336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 34000669A
- Practice address
- 59216 Merrimac LN
Elkhart, IN 46517-3415 - Phone
- (574) 875-6399
- Fax
- (574) 875-4184
- NPI assigned
- Jul 9, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 34000669A | IN | Primary |
Addresses
Primary practice location
59216 Merrimac LN
Elkhart, IN 46517-3415
Mailing address
59216 Merrimac LN
Elkhart, IN 46517-3415
Phone (574) 875-6399
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
| License | State | Type | Specialty |
|---|---|---|---|
| 34000669A | IN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063445336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "59216 MERRIMAC LN",
"city": "ELKHART",
"state": "IN",
"postal_code": "465173415",
"telephone_number": "574-875-6399",
"fax_number": "574-875-4184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "59216 MERRIMAC LN",
"city": "ELKHART",
"state": "IN",
"postal_code": "465173415",
"telephone_number": "574-875-6399",
"fax_number": "574-875-4184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUMP-CAMPAGNOLI",
"first_name": "GENEELE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "34000669A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elkhart, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.