Jay K Campbell, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61362298 Issued in WA

Practice address

516 W 4TH Ave
Toppenish, WA 98948-1616

Phone

(509) 865-2500

Fax

(509) 865-2623

NPI assigned

Sep 29, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Summit Solstice Counseling LLC

  • Mental Health Counselor
  • Yakima, WA
  • NPI 1225862303
  Medicare reassignment NPD Authorized official
• SHC Medical Center Toppenish

  • General Acute Care Hospital
  • Toppenish, WA
  • NPI 1851817308
  Medicare reassignment NPD

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

{
    "created_epoch": "1695945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1861272619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 W 4TH AVE",
            "city": "TOPPENISH",
            "state": "WA",
            "postal_code": "989481616",
            "telephone_number": "509-865-2500",
            "fax_number": "509-865-2623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 W 4TH AVE",
            "city": "TOPPENISH",
            "state": "WA",
            "postal_code": "989481616",
            "telephone_number": "509-865-2500",
            "fax_number": "509-865-2623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JAY",
        "middle_name": "K",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-29",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61362298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn Burwell, MD
• Cassandra Lee Byers, RD, CD
• Anthony Cacchiotti
• Antonio Cadengo Jr., RN
• Vlastimil Calayan
• May Mountain Hawk Campbell, PHARMD
• Sherran Marie Campos
• Care Center Toppenish Inc.
• Julio Carranza, DSW, MSW
• Maria Guadalupe Bello Carrillo, DDS

• Clinical Social Worker in Toppenish, WA
• Providers in Toppenish, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.