Active NPI
Mark Campanile, PSY.D.
- Clinical Psychologist
- Pottstown, PA
National Provider Identifier
1073980942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS017904
- Practice address
- 2091 E High St
Pottstown, PA 19464-3211 - Phone
- (610) 970-5234
- NPI assigned
- Aug 27, 2015
- Sex
- Male
- 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 | PS017904 | PA | Primary |
Addresses
Primary practice location
2091 E High St
Pottstown, PA 19464-3211
Mailing address
2091 E High St
Pottstown, PA 19464-3211
Phone (610) 970-5234
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Evergreen Counseling Associates | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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": "1440633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440633600000",
"number": "1073980942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2091 E HIGH ST",
"city": "POTTSTOWN",
"state": "PA",
"postal_code": "194643211",
"telephone_number": "610-970-5234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2091 E HIGH ST",
"city": "POTTSTOWN",
"state": "PA",
"postal_code": "194643211",
"telephone_number": "610-970-5234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPANILE",
"first_name": "MARK",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-27",
"last_updated": "2015-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS017904",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pottstown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.