Iden Campbell McCollum, CPS

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

043 Issued in DC

Practice address

700 Pennsylvania Ave SE FL 2
Washington, DC 20003-2493

Phone

(888) 963-1828

NPI assigned

Sep 9, 2025

Last updated

Sep 9, 2025By the provider in NPPES

Sex

Unspecified or another gender identity

Sole proprietor

No

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Beacon Tech Inc

  dba Marigold Health

  • Peer Specialist
  • Boston, MA
  • NPI 1710758289
  NPD

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

{
    "created_epoch": "1757376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1174404974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 COURT ST STE 220B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021082104",
            "telephone_number": "888-963-1828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 PENNSYLVANIA AVE SE FL 2",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200032493",
            "telephone_number": "888-963-1828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL MCCOLLUM",
        "first_name": "IDEN",
        "credential": "CPS",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-09-09",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "DC",
            "license": "043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Camp
• Nadine L. Camp, CPNP
• Kathryn L. Campana, PH.D.
• Erica Campanaro
• Veronica Campanella, M.D.
• Robin T Campbell-Bennett
• Alexis Campbell
• Alicia Campbell
• Andre Bruce Campbell, PA
• Bianca Campbell, MD, PHARMD

• Peer Specialist in Washington, DC
• Providers in Washington, DC by specialty
• Peer Specialist in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; 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.