Crystal Dawn Campbell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW23729 Issued in FL

Practice address

740 Greenwood Ave
Orange City, FL 32763-5710

Phone

(386) 269-8082

NPI assigned

Nov 15, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1731628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1124843198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 S PALMETTO AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 GREENWOOD AVE",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327635710",
            "telephone_number": "386-269-8082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "412 S Palmetto Ave",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321144922",
            "country_code": "US",
            "telephone_number": "386-269-8082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "CRYSTAL",
        "middle_name": "DAWN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-15",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW23729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ta-Queona Byrd
• Silvia Dubois Cabal, MA
• Rene Cabeza, MD
• Ryann Cahill
• Calm Corner Therapy LLC
• John Buckley Canalizo, MD
• Alfred H Cann III, O.D.
• Rene Capulong, MD
• Care Life Outreach Inc.
• Carenow Pharmacy LLC

• Clinical Social Worker in Orange City, FL
• Providers in Orange City, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.