Individual provider Active NPI

Jessica Ann Campbell, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1245497320
Registry record updated May 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12674 Issued in MD
Practice address
10 N Greene St
Baltimore, MD 21201-1524
Phone
(410) 605-7487
NPI assigned
May 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 12674 MD Primary

Addresses

Primary practice location

10 N Greene St
Baltimore, MD 21201-1524

Mailing address

3611 Rexmere Rd
Baltimore, MD 21218-2009
Phone (410) 243-8564

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12674MDMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1210982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210982400000",
    "number": "1245497320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 REXMERE RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212182009",
            "telephone_number": "410-243-8564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011524",
            "telephone_number": "410-605-7487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-17",
        "last_updated": "2008-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "12674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.