Individual provider Active NPI

Martine Debrosse Campbell, SOCIAL WORKER

  • School Counselor
  • Baldwin, NY
National Provider Identifier
1174285597
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
School CounselorTaxonomy code 101YS0200X
Practice address
732 Allwyn St
Baldwin, NY 11510-4529
Phone
(516) 662-1591
NPI assigned
Oct 13, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 000901 CT
School Counselor 101YS0200X NY Primary

Addresses

Primary practice location

732 Allwyn St
Baldwin, NY 11510-4529

Mailing address

732 Allwyn St
Baldwin, NY 11510-4529
Phone (516) 662-1591

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Baldwin Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
000901CTMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1174285597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 ALLWYN ST",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115104529",
            "telephone_number": "516-662-1591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 ALLWYN ST",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115104529",
            "telephone_number": "516-662-1591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBROSSE CAMPBELL",
        "first_name": "MARTINE",
        "name_prefix": "Mrs.",
        "credential": "SOCIAL WORKER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-13",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "000901",
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Baldwin",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Baldwin",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "732 Allwyn Street",
            "city": "Baldwin",
            "state": "NY",
            "country_code": "US",
            "postal_code": "11510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baldwin, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; 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.