Individual provider Active NPI

Natosha Labelle Campos, LPC, LMSW

  • Social Worker
  • Bridgeport, CT
National Provider Identifier
1265628200
Registry record updated Oct 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
01171 Issued in CT
Practice address
46 Albion St
Bridgeport, CT 06605-2602
Phone
(203) 330-6000
Fax
(203) 330-6008
NPI assigned
Sep 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Social Worker 104100000X 01171 CT Primary

Addresses

Primary practice location

46 Albion St
Bridgeport, CT 06605-2602

Mailing address

46 Albion St
Bridgeport, CT 06605-2602
Phone (203) 330-6000

Other identifiers 2

IdentifierTypeStateIssuer
001171OtherCTSTATE LICENSE
004236148MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241113003692 CT Practitioner - Mental Health Counselor 9830623834 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01171CTMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
South-West Community Health Center, Inc CurrentSince Sep 8, 2024 Accepting new patients

Locations

968 Fairfield Ave
Bridgeport, CT 06605

1046 Fairfield Ave
Bridgeport, CT 06605
Phone (203) 330-6054

510 Clinton Ave
Bridgeport, CT 06605
Phone (203) 366-4000

46 Albion St
Bridgeport, CT 06605
Phone (203) 332-3155

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1265628200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 ALBION ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066052602",
            "telephone_number": "203-330-6000",
            "fax_number": "203-330-6008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 ALBION ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066052602",
            "telephone_number": "203-330-6000",
            "fax_number": "203-330-6008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPOS",
        "first_name": "NATOSHA",
        "middle_name": "LABELLE",
        "name_prefix": "Mrs.",
        "credential": "LPC, LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-24",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "01171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "001171",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236148",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.