Dr. L M Campbell, LTD

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LP2631 Issued in MN

Legal business name

DR. L M CAMPBELL, LTD

Practice address

287 South Marschall Road
Suite 203
Shakopee, MN 55379

Phone

(952) 445-1397

Fax

(952) 445-1398

NPI assigned

Aug 5, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Lowell Mason Campbell III, LP

Title

Psychologist

Phone

(952) 445-1378

Specialties & licenses 1

Addresses

Other identifiers 7

Locations

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590019200000",
    "number": "1346259041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "287 SOUTH MARSCHALL ROAD",
            "address_2": "PO BOX 336 SUITE 203",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "55379",
            "telephone_number": "952-445-1397",
            "fax_number": "952-445-1398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 SOUTH MARSCHALL ROAD",
            "address_2": "SUITE 203",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "55379",
            "telephone_number": "952-445-1397",
            "fax_number": "952-445-1398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. L M CAMPBELL, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2020-05-21",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "LOWELL",
        "authorized_official_middle_name": "MASON",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "952-445-1378",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "LP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "LP2631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID",
            "identifier": "51053CA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA ID",
            "identifier": "61-20043",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL SECURITY",
            "identifier": "$$$$$$$$$",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE ID",
            "identifier": "01010981",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORP NPI",
            "identifier": "1659393684",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP ID",
            "identifier": "51217CA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS ID",
            "identifier": "HP19455",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Shakopee, MN
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; 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.