Keegan Daniel Campbell, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

DP00945310 Issued in WV

Practice address

235 High St Ste 509
Morgantown, WV 26505-5454

Phone

(304) 996-3639

NPI assigned

Mar 14, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Blue Cardinal Counseling PLLC

  • Clinical Social Worker
  • Morgantown, WV
  • NPI 1659068724

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1678752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1124729306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 HIGH ST STE 509",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265055454",
            "telephone_number": "304-996-3639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 HIGH ST STE 509",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265055454",
            "telephone_number": "304-996-3639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "KEEGAN",
        "middle_name": "DANIEL",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-14",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "DP00945310",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WV",
            "license": "DP00945310",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WEST VIRGINIA BOARD OF SOCIAL WORK",
            "identifier": "DP00945310",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Camillone
• Camp Road Project Associates LLC
• Janella Camp
• Rosetta Campbell Reese, MD, MPH
• Kacy Campbell
• Kristen Campbell
• Marcia Campbell
• Melissa Ann Campbell
• Sharon Campbell
• Stephani Campbell

• Clinical Social Worker in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Clinical Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.