Individual provider Active NPI

Elizabeth Harkey Campbell, PHD

  • Psychologist
  • Orlando, FL
National Provider Identifier
1760496129
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY6141 Issued in FL
Practice address
654 N Econlockhatchee Trail
Palm Garden Orlando
Orlando, FL 32825
Phone
(407) 273-6158
NPI assigned
Jul 28, 2006
Last updated
May 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY6141 FL Primary
Clinical Psychologist 103TC0700X PY6141 FL

Addresses

Primary practice location

654 N Econlockhatchee Trail
Palm Garden Orlando
Orlando, FL 32825

Mailing address

3805 Biscayne Dr
Winter Springs, FL 32708-4628

Other identifiers 1

IdentifierTypeStateIssuer
8111472MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050727001035 FL Practitioner - Clinical Psychologist 9436187853 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ace Behavioral Health LLCGroup PAC ID 2668984675, 38 clinicians

Practice addresses (Care Compare)

232 N Orange Blossom TRL
Orlando, FL 32805-1612
Phone 4074285751329

5406 Hoover Blvd
Suite 18
Tampa, FL 33634-5330
Phone (866) 770-4104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY6141FLMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
MCR Health, Inc. CurrentSince Jun 16, 2014 Accepting new patients
Citrus County Rural Health Inc CurrentSince Sep 1, 2025 Accepting new patients
MCR Health, Inc. CurrentSince Jun 16, 2014 Accepting new patients
Ace Behavioral Health LLC Psychologist CurrentSince May 1, 2025 Accepting new patients

Locations

725 N 12th Ave
Ste B
Arcadia, FL 34266

927 N Citrus Ave
Crystal River, FL 34428
Phone (352) 404-5588

700 8th Ave W
Ste 101
Palmetto, FL 34221
Phone (941) 776-4008

12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231

5406 Hoover Blvd
Ste 18
Tampa, FL 33634
Phone (813) 880-7577

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1760496129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805 BISCAYNE DR",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327084628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 N ECONLOCKHATCHEE TRAIL",
            "address_2": "PALM GARDEN ORLANDO",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32825",
            "telephone_number": "407-273-6158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "ELIZABETH",
        "middle_name": "HARKEY",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY6141",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY6141",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8111472",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.