Edna Lea Campbell, LPC-S

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

P1609141 Issued in AR

Practice address

2224 Apache St
Choctaw, OK 73020-3005

Phone

(708) 882-7484

NPI assigned

Apr 22, 2014

Last updated

Nov 13, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Edna Lea Thompson Other name

Medicare fee-for-service enrollment

Enrolled in OK

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• This Is the Way Counseling, LLC

  • Counselor
  • Choctaw, OK
  • NPI 1750105755
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1398124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1104246867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2224 APACHE ST",
            "city": "CHOCTAW",
            "state": "OK",
            "postal_code": "730203005",
            "telephone_number": "708-882-7484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2224 APACHE ST",
            "city": "CHOCTAW",
            "state": "OK",
            "postal_code": "730203005",
            "telephone_number": "708-882-7484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "EDNA",
        "middle_name": "LEA",
        "credential": "LPC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-22",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "10228",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P1609141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDNA",
            "last_name": "THOMPSON",
            "middle_name": "LEA",
            "credential": "LPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Bailey Brooks, BABHP
• Samantha Lyne Brown
• Bruce a. Stafford, DO, PC
• Roger Lynn Bryant, D.D.S.
• Molly Beth Bullard, APRN
• Maria Caram, MS, BCBA
• Stephanie Michelle Cargo, RD/LD CNSC
• Sabre Carlile
• Cary Lee Carpenter, M.D.
• Carrie Carter, PHARM D

• Professional Counselor in Choctaw, OK
• Providers in Choctaw, OK by specialty
• Professional Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.