Kelly Sue Campbell, LISW, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I-1100007 Issued in OH

Practice address

195 Union St
Suite B-1
Newark, OH 43055-3919

Phone

(740) 349-7066

Fax

(740) 345-6028

NPI assigned

Jun 7, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Equitas Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Toledo, OH
  • NPI 1063239911
  NPD (past)

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339027200000",
    "number": "1144581992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 UNION ST",
            "address_2": "SUITE B-1",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430553919",
            "telephone_number": "740-349-7066",
            "fax_number": "740-345-6028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 UNION ST",
            "address_2": "SUITE B-1",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430553919",
            "telephone_number": "740-349-7066",
            "fax_number": "740-345-6028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "KELLY",
        "middle_name": "SUE",
        "credential": "LISW, MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-07",
        "last_updated": "2012-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I-1100007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "I-1100007",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Ann Caito-Satterfield
• Linda S Camelo, LISW-S
• Amy Marie Camp
• Emily L Campbell
• Jeremy Campbell, DO
• Robin R Campbell, COTA/L
• Terra A Campbell
• Tiffiny Erin Campbell, LPN
• Alexander Campolo, D.O.
• Michael Eugene Campolo, DO

• Clinical Social Worker in Newark, OH
• Providers in Newark, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; 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.