Tiffany Campbell

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LPC-9614 Issued in ID

Practice address

1001 N 7TH Ave Ste 260
Pocatello, ID 83201-5788

Phone

(208) 223-1309

NPI assigned

Jul 10, 2023

Last updated

Jul 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• D6 Treatment

  • Addiction (Substance Use Disorder) Counselor
  • Pocatello, ID
  • NPI 1689218018
  NPD

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1245918093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 N 7TH AVE STE 260",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015788",
            "telephone_number": "208-223-1309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N 7TH AVE STE 260",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015788",
            "telephone_number": "208-223-1309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ID",
            "license": "LPC-9614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Calleen Cannon Counseling LLC (Calleen Cannon Counseling)
• Corina Jean Cameron, STUDENT PHARMACIST
• David M Cameron, M.D.
• Marlene Cameron, PT
• James Matthew Campbell, PA-C
• Trinety Lynn Campbell, LCSW
• Candlewood Family Counseling Center, Inc.
• Candlewood Family Counseling Center, Inc.
• Candlewood Family Counseling Center, Inc.
• Candlewood Family Counseling Center, Inc.

• Addiction (Substance Use Disorder) Counselor in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Addiction (Substance Use Disorder) Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.