Kimberly Campbell, LPC – Mental Health Counselor

Key facts

NPI: 1780150151
Entity type: Individual (NPI type 1)
Primary specialty: Mental Health Counselor 101YM0800X
License: 2475 (OK)
Practice address: 6612 NW 42ND Street
Bethany, OK 73008
Phone: (405) 924-1850
NPI assigned: Oct 23, 2018
Sex: Female
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Southern Nazarene University Mental Health Counselor · Bethany, OK · NPI 1871069245

NPD (past) MENTAL HEALTH

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
2475	OK	MD	Physician Assistant

Practice roles

Organization	Specialty	Status	New patients
Southern Nazarene University	Mental Health	Past since Oct 24, 2021	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Mental Health Counselor	101YM0800X	2475	OK	Yes

Addresses

Primary practice location

6612 NW 42ND Street
Bethany, OK 73008

Mailing address

6612 NW 42ND Street
Bethany, OK 73008
Phone (405) 924-1850

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 23, 2018.

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540252800000",
    "number": "1780150151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6612 NW 42ND STREET",
            "city": "BETHANY",
            "state": "OK",
            "postal_code": "73008",
            "telephone_number": "405-924-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6612 NW 42ND STREET",
            "city": "BETHANY",
            "state": "OK",
            "postal_code": "73008",
            "telephone_number": "405-924-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "KIMBERLY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-23",
        "last_updated": "2018-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "2475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethany, OK

All providers in Bethany, OK · Mental Health Counselor in Oklahoma

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2018. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.