Individual provider Active NPI

Yvonne Campbell, LCSW

  • Clinical Social Worker
  • Glen Allen, VA
National Provider Identifier
1295843902
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904002644 Issued in VA
Practice address
4191 Innslake Dr Ste 211
Glen Allen, VA 23060-3324
Phone
(804) 303-9622
Fax
(804) 716-4318
NPI assigned
Aug 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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 0904002644 VA Primary

Addresses

Primary practice location

4191 Innslake Dr Ste 211
Glen Allen, VA 23060-3324

Mailing address

4191 Innslake Dr Ste 211
Glen Allen, VA 23060-3324
Phone (804) 303-9622

Other practice location 1

2808 Fox Chase Ln
Midlothian, VA 23112-4008
Phone (804) 303-9622

Other practice location 2

1503 Santa Rosa Rd Rm 211
Henrico, VA 23229-5105
Phone (804) 303-9622

Other identifiers 1

IdentifierTypeStateIssuer
8922934MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20050503000635 VA Practitioner - Clinical Social Worker 5496794075 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Zoe Therapy Services, LLCGroup PAC ID 2769603901, 31 clinicians

Practice addresses (Care Compare)

7201 Glen Forest Dr
Suite 304
Richmond, VA 23226-3759
Phone (804) 303-9622

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904002644VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Zoestyle Medicine CurrentSince Jul 28, 2022 Accepting new patients
Zoe Therapy Services, LLC Clinical CurrentSince Aug 9, 2014 Accepting new patients

Locations

4191 Innslake Dr
Glen Allen, VA 23060

4191 Innslake Dr
Ste 211
Glen Allen, VA 23060
Phone (804) 303-9622

2808 Fox Chase Ln
Midlothian, VA 23112
Phone (804) 303-9622

1503 Santa Rosa Rd
Rm 211
Richmond, VA 23229
Phone (804) 282-9100

7201 Glen Forest Dr
Ste 304
Richmond, VA 23226
Phone (804) 303-9622

Organizations & group practices 2

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1295843902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4191 INNSLAKE DR STE 211",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603324",
            "telephone_number": "804-303-9622",
            "fax_number": "047-164-3188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4191 INNSLAKE DR STE 211",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603324",
            "telephone_number": "804-303-9622",
            "fax_number": "804-716-4318"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2808 Fox Chase Ln",
            "address_purpose": "LOCATION",
            "city": "Midlothian",
            "state": "VA",
            "postal_code": "231124008",
            "country_code": "US",
            "telephone_number": "804-303-9622",
            "fax_number": "804-716-4318",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1503 Santa Rosa Rd Rm 211",
            "address_purpose": "LOCATION",
            "city": "Henrico",
            "state": "VA",
            "postal_code": "232295105",
            "country_code": "US",
            "telephone_number": "804-303-9622",
            "fax_number": "804-716-4318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "YVONNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904002644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8922934",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

Verify at the official NPI Registry.