Audrey Green-Campbell

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC009467 Issued in GA

Practice address

224 Central LN
Tifton, GA 31794-4423

Phone

(804) 869-1096

NPI assigned

Dec 15, 2006

Last updated

Dec 9, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702080000000",
    "number": "1649332644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2823 RAINWATER RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317935700",
            "telephone_number": "804-869-1096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 CENTRAL LN",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317944423",
            "telephone_number": "804-869-1096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN-CAMPBELL",
        "first_name": "AUDREY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2023-12-09",
        "certification_date": "2023-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC009467",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701003962",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Medical Transport LLC
• Deraine H Graham, NP
• James L Graham Jr., MD
• Ravi Kiran Grandhi, MD
• Christopher Gravitt, FNP-C
• Kalimbria Jantia Green
• Charles W Griffin, MD
• Christie Long Griffin, APRN, AGNP-C
• Dixie Dawn Griffin, MD
• Gracie Lucille Elizabeth Griffin, RPH

• Professional Counselor in Tifton, GA
• Providers in Tifton, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2023; 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.