Active NPI
Jessica Rena Campbell, PCC
- Professional Counselor
- Madeira, OH
National Provider Identifier
1194851634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- E0500044
- Practice address
- 7843 Laurel Ave
Madeira, OH 45243-2608 - Phone
- (513) 561-5600
- NPI assigned
- Feb 26, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | E0500044 | OH | Primary |
Addresses
Primary practice location
7843 Laurel Ave
Madeira, OH 45243-2608
Mailing address
5838 Highview Dr
Milford, OH 45150-2038
Phone (513) 305-1437
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
| License | State | Type | Specialty |
|---|---|---|---|
| E0500044 | OH | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194851634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5838 HIGHVIEW DR",
"city": "MILFORD",
"state": "OH",
"postal_code": "451502038",
"telephone_number": "513-305-1437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7843 LAUREL AVE",
"city": "MADEIRA",
"state": "OH",
"postal_code": "452432608",
"telephone_number": "513-561-5600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "JESSICA",
"middle_name": "RENA",
"credential": "PCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "E0500044",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madeira, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.