Michael S. Campbell, PHDLCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

SW4769 Issued in FL

Practice address

1717 S Orange Ave
Suite 100
Orlando, FL 32806-2944

Phone

(407) 650-7000

Fax

(407) 650-7124

NPI assigned

Nov 2, 2006

Sex

Male

Sole proprietor

No

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

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315353600000",
    "number": "1578641734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "address_2": "PROVIDER ENROLLMENT DEPT",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "telephone_number": "302-651-6212",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 S ORANGE AVE",
            "address_2": "SUITE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062944",
            "telephone_number": "407-650-7000",
            "fax_number": "407-650-7124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "MICHAEL",
        "middle_name": "S.",
        "name_prefix": "Mr.",
        "credential": "PHDLCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2011-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "SW4769",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW4769",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "FL",
            "license": "SW4769",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Clinton Campbell, APRN, FNP-C
• Kimberly Renee Campbell
• Kristen V Campbell
• Libby Theo Campbell, PHD LMHC
• Maryjane Campbell, PHD
• Qwanda Campbell
• Robert M Campbell
• Roche Keegan Campbell, CSTFA
• Rose Marie Campbell, MSW
• Sherece Shadae Campbell

• Social Worker in Orlando, FL
• Providers in Orlando, FL by specialty
• Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; 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.