Individual provider Active NPI

Kirk Charles Campbell, LCDC

  • Addiction (Substance Use Disorder) Counselor
  • Houston, TX
National Provider Identifier
1609931419
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
7728 Issued in TX
Practice address
6699 Portwest Drive
Suite 140
Houston, TX 77024-8002
Phone
(713) 528-6720
Fax
(713) 520-6720
NPI assigned
Dec 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 7728 TX Primary

Addresses

Primary practice location

6699 Portwest Drive
Suite 140
Houston, TX 77024-8002

Mailing address

PO Box 130938
Houston, TX 77219-0938
Phone (713) 528-6720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7728TXMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Recovery Inc Addiction (Substance Use Disorder) Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1609931419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130938",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772190938",
            "telephone_number": "713-528-6720",
            "fax_number": "713-520-6720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6699 PORTWEST DRIVE",
            "address_2": "SUITE 140",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770248002",
            "telephone_number": "713-528-6720",
            "fax_number": "713-520-6720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "KIRK",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "LCDC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "7728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; 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.