Elizabeth McCampbell PHD PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

894 Issued in GA

Legal business name

ELIZABETH MCCAMPBELL PHD PC

Practice address

3325 Paddocks Pkwy Ste 415
Suwanee, GA 30024-6059

Phone

(404) 216-0252

NPI assigned

Dec 30, 2008

Last updated

Feb 20, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Micheaux Hall

Title

Office Manager

Phone

(678) 513-0313

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Barry Leonard Klein, PH.D.

  • Psychologist
  • Suwanee, GA
  • NPI 1184658965
  NPD

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

{
    "created_epoch": "1230595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676851200000",
    "number": "1154567824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5285 MARSTON RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303601226",
            "telephone_number": "404-216-0252",
            "fax_number": "678-513-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 PADDOCKS PKWY STE 415",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246059",
            "telephone_number": "404-216-0252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3890 Johns Creek Pkwy Ste 250",
            "address_purpose": "LOCATION",
            "city": "Suwanee",
            "state": "GA",
            "postal_code": "300246602",
            "country_code": "US",
            "telephone_number": "404-216-0252",
            "fax_number": "678-513-1188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ELIZABETH MCCAMPBELL PHD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-30",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "MICHEAUX",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "678-513-0313"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1154567824",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000277109A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL",
            "identifier": "1386626000",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.