Mary Campbell, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC010634 Issued in GA

Practice address

1264 Concord Rd SE Ste 106
Smyrna, GA 30080-5302

Phone

(678) 424-8650

Fax

(678) 424-8652

NPI assigned

Dec 3, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Mental Health Counselor

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Thrive Counseling LLC

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  GA, Single Specialty

  Medicare reassignment Care Compare group NPD
• Angela Ronay Richardson

  • Professional Counselor
  • Smyrna, GA
  • NPI 1114460243
  NPD (past)
• Reconnect Therapeutic Associates LLC.

  • Mental Health Counselor
  • Smyrna, GA
  • NPI 1760933287

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1543795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1447720453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1264 CONCORD RD SE STE 106",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300805302",
            "telephone_number": "678-424-8650",
            "fax_number": "678-424-8652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1264 CONCORD RD SE STE 106",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300805302",
            "telephone_number": "678-424-8650",
            "fax_number": "678-424-8652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "MARY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-03",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC010634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Caldwell-Lawson, LCSW
• Caliswift LLC
• Camelot Healthcare Management Inc
• Candice Leah Campbell, M.S. CCC-SLP
• Jakayla Campbell, ATC
• Candler Road Dental, PC
• Candy Bear Pediatrics Telemedicine LLC
• Myia Canidate, LPN
• Chadwick Cantrell
• Tania Maria Capparelli, LMFT

• Professional Counselor in Smyrna, GA
• Providers in Smyrna, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.