Jacquetta Denise Campbell, LCMHC-A

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

A21191 Issued in NC

Practice address

2315 E WT Harris Blvd Ste 102
Charlotte, NC 28213-5133

Phone

(704) 208-4458

Fax

(866) 309-6385

NPI assigned

Apr 15, 2025

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1744675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1497541809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2261 DONNINGTON LN NW",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280273322",
            "telephone_number": "704-754-7817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 E WT HARRIS BLVD STE 102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282135133",
            "telephone_number": "704-208-4458",
            "fax_number": "866-309-6385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JACQUETTA",
        "middle_name": "DENISE",
        "credential": "LCMHC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-15",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A21191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haley Denise Campbell, BSW
• Heather Eisenson Campbell
• Heidi Campbell, CD(DONA), MBA, CMR
• Hubert Alan Campbell, LCMHCA
• Jacqueline A Campbell, LRT
• Jamie Alexis Weaver Campbell, DO
• Jessica Campbell
• Jessica Kate Campbell, PA
• Julie Kathleen Campbell, LCSW
• Keith Mark Campbell, LCAS

• Professional Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; 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.