Individual provider Active NPI

Mary Joanne Campbell

  • Clinical Social Worker
  • Grand Blanc, MI
National Provider Identifier
1245978121
Registry record updated May 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
10683 S Saginaw St Ste B
Grand Blanc, MI 48439-8127
Phone
(810) 771-4074
NPI assigned
May 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2022

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 Primary

Addresses

Primary practice location

10683 S Saginaw St Ste B
Grand Blanc, MI 48439-8127

Mailing address

3738 Norwood Dr
Flint, MI 48503-2326

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

NPI Registry JSON

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

{
    "created_epoch": "1653091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653091200000",
    "number": "1245978121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3738 NORWOOD DR",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10683 S SAGINAW ST STE B",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398127",
            "telephone_number": "810-771-4074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "MARY",
        "middle_name": "JOANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-21",
        "last_updated": "2022-05-21",
        "certification_date": "2022-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2022; 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.