Mary Lavinia Campbell, LCSWR, CDE

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

R-0376750 Issued in NY

Practice address

80 E 11TH St
438
New York, NY 10003-6811

Phone

(212) 533-3884

Fax

(718) 855-3004

NPI assigned

May 20, 2009

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

• Mrs. Lin X Campbell Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242777600000",
    "number": "1194950154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 E 11TH ST",
            "address_2": "438",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100036811",
            "telephone_number": "212-533-3884",
            "fax_number": "718-855-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 E 11TH ST",
            "address_2": "438",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100036811",
            "telephone_number": "212-533-3884",
            "fax_number": "718-855-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "MARY",
        "middle_name": "LAVINIA",
        "name_prefix": "Mrs.",
        "credential": "LCSWR, CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-20",
        "last_updated": "2009-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "R-0376750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIN",
            "last_name": "CAMPBELL",
            "middle_name": "X",
            "prefix": "MRS.",
            "credential": "LCSWR, CDE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Krystine Campbell, LMSW
• Lisa Campbell, P.A.
• Louis Frank Campbell, D.C.
• Lydia Campbell, CPNP
• Margie Dawn Campbell, M.D.
• Megan Campbell
• Megan T Campbell, LMSW
• Michael Darren Campbell, MD
• Michelle Campbell, LPN
• Molly Campbell

• Behavior Analyst in New York, NY
• Providers in New York, NY by specialty
• Behavior Analyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; 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.