Jennifer L Campbell, MA, LLP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301014102 Issued in MI

Practice address

114 Tuscola
Bay City, MI 48708-6995

Phone

(989) 895-0788

Fax

(989) 895-0799

NPI assigned

Feb 24, 2011

Last updated

Dec 1, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jennifer L Kern Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Sep 30, 2016 through Sep 30, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1298505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448928000000",
    "number": "1821395039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 TUSCOLA RD.",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487086995",
            "telephone_number": "989-895-0788",
            "fax_number": "989-895-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 TUSCOLA",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487086995",
            "telephone_number": "989-895-0788",
            "fax_number": "989-895-0799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "MA, LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-24",
        "last_updated": "2015-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301014102",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301014102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "KERN",
            "middle_name": "L",
            "credential": "MA, LLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christina Lynn Callaghan, R.PH.
• Calmwave Counseling PLLC
• Lisa Camero
• James C Campau, D.O.
• Jennafer Marie Campbell, LPTA
• Shelly Cleland Campbell
• Canises LLC
• Laura Card, M.A. CF- SLP
• Shiloh Peyton Carder
• Cardinal Comfort LLC

• Clinical Psychologist in Bay City, MI
• Providers in Bay City, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.