Jackie Campbell Counseling

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

107659 Issued in AK

Legal business name

JACKIE CAMPBELL COUNSELING

Practice address

9000 Glacier Hwy Ste 305
Juneau, AK 99801-8097

Phone

(907) 209-0246

NPI assigned

Aug 9, 2016

Organization subpart

No

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

Authorized official

Name

Jacqueline Marie Campbell, LCSWNPI 1720401680

Title

Counselor

Phone

(907) 209-0246

Specialties & licenses 1

Addresses

Other names 1

• Jackie Campbell Counseling Other name

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Locations

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacqueline Campbell

  • Clinical Social Worker
  • Juneau, AK
  • NPI 1720401680

  AK, Clinical

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616544000000",
    "number": "1184178014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 GLACIER HWY STE 305",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998018097",
            "telephone_number": "907-209-0246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 GLACIER HWY STE 305",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998018097",
            "telephone_number": "907-209-0246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKIE CAMPBELL COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-09",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "907-209-0246",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "107659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackie Campbell Counseling",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Jackie Campbell Counseling",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ryan Isadore
• Isc Ketchikan-Juneau Detachment
• Andrea S Iverson, DC, DABCO
• Becky A Iverson
• Cheryl A Jack
• Keegan Marie Jackson, M.D.
• Sylina Jackson
• Frank David Joseph Jacob
• Katie Dawn Jacobs
• Lora Jae

• All providers in Juneau, AK
• Clinical Social Worker in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; 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.