Active NPI
Doreen T Campbell, LISW
- Clinical Social Worker
- Santa Fe, NM
National Provider Identifier
1720394661
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I-08396
- Practice address
- 1574 State Road 502
Santa Fe, NM 87506-2697 - Phone
- (505) 455-4026
- Fax
- (505) 455-4038
- NPI assigned
- Aug 30, 2010
- Last updated
- May 20, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I-08396 | NM | Primary |
Addresses
Primary practice location
1574 State Road 502
Santa Fe, NM 87506-2697
Mailing address
P O Box 237
El Rito, NM 87530
Phone (575) 581-4728
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E7436 | Medicaid | NM |
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 |
|---|---|---|---|
| I-08396 | NM | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Las Clinicas del Norte Incorporated | Past | Accepting new patients | |
| Las Clinicas del Norte Incorporated | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Las Clincias del Norte - Los Alamos
- Clinic/Center
- Los Alamos, NM
- NPI 1194372789
-
dba Pojoaque Valley High School Based Clinic
- Student Health Clinic/Center
- Santa Fe, NM
- NPI 1508035718
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432080000000",
"number": "1720394661",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P O BOX 237",
"city": "EL RITO",
"state": "NM",
"postal_code": "87530",
"telephone_number": "575-581-4728",
"fax_number": "575-581-0030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1574 STATE ROAD 502",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875062697",
"telephone_number": "505-455-4026",
"fax_number": "505-455-4038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "DOREEN",
"middle_name": "T",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-30",
"last_updated": "2015-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "I-08396",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "E7436",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.