Individual provider Active NPI

Marilyn Laila Sampilo, LMLP

  • Clinical Psychologist
  • Columbus, OH
National Provider Identifier
1851689491
Registry record updated Dec 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7511 Issued in OH
Practice address
700 Childrens Dr
Psychology Department
Columbus, OH 43205-2664
Phone
(614) 722-4700
Fax
(614) 722-4718
NPI assigned
Jul 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1397 KS
Clinical Psychologist 103TC0700X 7511 OH Primary

Addresses

Primary practice location

700 Childrens Dr
Psychology Department
Columbus, OH 43205-2664

Mailing address

700 Childrens Dr
Psychology Department
Columbus, OH 43205-2664
Phone (614) 722-4700

Other identifiers 1

IdentifierTypeStateIssuer
1473276MedicaidOH

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
7511OHMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480982400000",
    "number": "1851689491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "address_2": "PSYCHOLOGY DEPARTMENT",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-4700",
            "fax_number": "614-722-4718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "address_2": "PSYCHOLOGY DEPARTMENT",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-4700",
            "fax_number": "614-722-4718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPILO",
        "first_name": "MARILYN",
        "middle_name": "LAILA",
        "name_prefix": "Ms.",
        "credential": "LMLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-18",
        "last_updated": "2016-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "1397",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "7511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1473276",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; 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.