Jennifer Patricia Campbell, MA, LPC, CCDP-D

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2008010475 Issued in MO

Practice address

939 Gardenview Office Pkwy
Creve Coeur, MO 63141-5917

Phone

(314) 566-2290

NPI assigned

Feb 6, 2010

Last updated

Feb 6, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifercampbell@tdh.allscriptsdirect.net

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  MO, Professional

  Medicare reassignment NPD
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Counselor

  NPD

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

{
    "created_epoch": "1265414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265414400000",
    "number": "1306178918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9433 THEODOSIA AVE",
            "city": "OVERLAND",
            "state": "MO",
            "postal_code": "631143715",
            "telephone_number": "314-566-2290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 GARDENVIEW OFFICE PKWY",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631415917",
            "telephone_number": "314-566-2290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JENNIFER",
        "middle_name": "PATRICIA",
        "credential": "MA, LPC, CCDP-D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-06",
        "last_updated": "2010-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MO",
            "license": "2008010475",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MO",
            "license": "5030",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2008010475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Perez Burghart, OD
• Summer Ann Burmeister
• Nathaniel Larue Burney, ATC
• Hannah Byers, NP
• Alfredo Rene Calderon, DDS
• Rosemary Louise Cannistraro, M.D. PHD
• Patti Ann Carbol, M.S.CCC-SLP
• Care Pharmaccyllc
• Care Pharmacy LLC
• Carepartners & Co., LLC

• Professional Counselor in Creve Coeur, MO
• Providers in Creve Coeur, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2010; 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.