Individual provider Active NPI

Dwaine Steven Campbell, PH.D, L.P.

  • Counseling Psychologist
  • Ann Arbor, MI
National Provider Identifier
1205777364
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
6301013123 Issued in MI
Practice address
2311 E Stadium Blvd Ste 212-5
Ann Arbor, MI 48104-4833
Phone
(734) 489-1994
NPI assigned
Apr 2, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 6301013123 MI Primary

Addresses

Primary practice location

2311 E Stadium Blvd Ste 212-5
Ann Arbor, MI 48104-4833

Mailing address

2232 S Main St # 136
Ann Arbor, MI 48103-6938
Phone (734) 489-1994

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301013123MIMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1775088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1205777364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2232 S MAIN ST # 136",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036938",
            "telephone_number": "734-489-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 E STADIUM BLVD STE 212-5",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044833",
            "telephone_number": "734-489-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "DWAINE",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "PH.D, L.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-04-02",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6301013123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; 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.