NPIMap

Organization Active NPI

Campbell Integrative Psychological Services

  • Clinical Psychologist
  • MC Lean, VA
National Provider Identifier
1750020954
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
CAMPBELL INTEGRATIVE PSYCHOLOGICAL SERVICES
Practice address
8200 Greensboro Dr Ste 900
MC Lean, VA 22102-4931
Phone
(571) 255-9859
NPI assigned
Jun 3, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Authorized official

Name
Dr. Shushan CampbellNPI 1265849822
Title
Psychologist/Clinucal Director
Phone
(571) 255-9859

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X Primary
Clinical Child & Adolescent PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC2200X
Family PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TF0000X
Intellectual & Developmental Disabilities PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TM1800X

Addresses

Primary practice location

8200 Greensboro Dr Ste 900
MC Lean, VA 22102-4931

Mailing address

8200 Greensboro Dr Ste 900
MC Lean, VA 22102-4931

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Campbellintegrativepsychologicalservices.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654214400000",
    "number": "1750020954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 GREENSBORO DR STE 900",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221024931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 GREENSBORO DR STE 900",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221024931",
            "telephone_number": "571-255-9859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMPBELL INTEGRATIVE PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-03",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "SHUSHAN",
        "authorized_official_title_or_position": "PSYCHOLOGIST/CLINUCAL DIRECTOR",
        "authorized_official_telephone_number": "571-255-9859",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Campbellintegrativepsychologicalservices.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8200 Greensboro Dr Ste 900",
            "city": "Mc Lean",
            "state": "VA",
            "country_code": "US",
            "postal_code": "221024931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in MC Lean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; 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.