Shirley Jane Campbell, MS,MED

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

001064 Issued in CT

Practice address

43 Sherman Hill Rd
BLDG D-Suite 203
Woodbury, CT 06798-3651

Phone

(203) 266-4142

NPI assigned

Jun 2, 2008

Last updated

Jun 2, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Shirley Jane Campbell Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education, Master of Science

State licenses

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212364800000",
    "number": "1174782536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 SHERMAN HILL RD",
            "address_2": "BLDG D-SUITE 203",
            "city": "WOODBURY",
            "state": "CT",
            "postal_code": "067983651",
            "telephone_number": "203-266-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 SHERMAN HILL RD",
            "address_2": "BLDG D-SUITE 203",
            "city": "WOODBURY",
            "state": "CT",
            "postal_code": "067983651",
            "telephone_number": "203-266-4142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "SHIRLEY",
        "middle_name": "JANE",
        "name_prefix": "Ms.",
        "credential": "MS,MED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2008-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "001064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHIRLEY",
            "last_name": "CAMPBELL",
            "middle_name": "JANE",
            "credential": "MS,MED",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Mental Health Counselor in Woodbury, CT
• Providers in Woodbury, CT by specialty
• Mental Health Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; 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.