Collyn Deshae Campbell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3160 Issued in OK

Practice address

16713 Prado Dr
Oklahoma City, OK 73170-6657

Phone

(405) 650-2983

NPI assigned

May 22, 2008

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

Other names 1

• Mrs. Collyn Deshae Moone Former name

Medicare fee-for-service enrollment

Enrolled in OK

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

Clinical Social Worker

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Balance Womens Health LLCGroup PAC ID 3476927740, 89 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Balance Women'S Health, LLC

  • Clinical Psychologist
  • Moore, OK
  • NPI 1790186385
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1497912745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16713 PRADO DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731706657",
            "telephone_number": "405-650-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16713 PRADO DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731706657",
            "telephone_number": "405-650-2983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "COLLYN",
        "middle_name": "DESHAE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-22",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "3160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLYN",
            "last_name": "MOONE",
            "middle_name": "DESHAE",
            "prefix": "MRS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Andrea Campbell
• Braden Trey Campbell
• Brett T Campbell, MA, RDN, LD
• Carolynn Lea Campbell
• Casey Elizabeth Campbell, MS, RD, LD
• Essence Campbell
• Francis Lauraine Campbell
• Hayley B. Campbell, RN, BSW
• Holly Ann Campbell, RD, LD
• Jaivionte Campbell

• Clinical Social Worker in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Clinical Social Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.