Active NPI
Mary E Campise
- Clinical Social Worker
- Dumfries, VA
National Provider Identifier
1619448131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1020822
- Practice address
- 4751 Timber Ridge Dr
Dumfries, VA 22025-1081 - Phone
- (301) 257-5782
- NPI assigned
- Dec 10, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1020822-SW-LICSW | ||
| Clinical Social Worker | 1041C0700X | 1020822 | MA | Primary |
Addresses
Primary practice location
4751 Timber Ridge Dr
Dumfries, VA 22025-1081
Mailing address
4751 Timber Ridge Dr
Dumfries, VA 22025-1081
Phone (301) 257-5782
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1020822 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544400000000",
"number": "1619448131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4751 TIMBER RIDGE DR",
"city": "DUMFRIES",
"state": "VA",
"postal_code": "220251081",
"telephone_number": "301-257-5782"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4751 TIMBER RIDGE DR",
"city": "DUMFRIES",
"state": "VA",
"postal_code": "220251081",
"telephone_number": "301-257-5782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPISE",
"first_name": "MARY",
"middle_name": "E",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-10",
"last_updated": "2018-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": "1020822-SW-LICSW",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "1020822",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dumfries, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.