Mark V Campbell

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC011026 Issued in PA

Practice address

4380 W 12TH St Ste 2a
Erie, PA 16505-3028

Phone

(814) 881-5277

Fax

(814) 833-3019

NPI assigned

Jan 16, 2019

Sex

Male

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

Enrolled in PA

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

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1144794884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4380 W 12TH ST STE 3A",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165053028",
            "telephone_number": "814-392-3888",
            "fax_number": "814-833-3019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4380 W 12TH ST STE 2A",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165053028",
            "telephone_number": "814-881-5277",
            "fax_number": "814-833-3019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "MARK",
        "middle_name": "V",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-16",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC011026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Reed Cammarata, DO
• Abbigail Grace Camp
• Alexis Campbell, OT
• Janet Campbell, LPC, LPN
• Julia Campbell
• Mitchell Campbell, DC
• Nicole Danielle Campbell, PT
• Pamela Sue Campbell, R.D., L.D.N., C.D.E.
• Philip W. Campbell, CRNA
• Rebecca Campbell, OD

• Professional Counselor in Erie, PA
• Providers in Erie, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.