Individual provider Active NPI

Monica Barson Campbell, MFC

  • Marriage & Family Therapist
  • South Lake Tahoe, CA
National Provider Identifier
1861525628
Registry record updated Sep 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
46451 Issued in CA
Practice address
3320 Sandy Way
Suite 4
South Lake Tahoe, CA 96150-8192
Phone
(775) 450-8339
Fax
(530) 542-2791
NPI assigned
Mar 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 46451 CA Primary

Addresses

Primary practice location

3320 Sandy Way
Suite 4
South Lake Tahoe, CA 96150-8192

Mailing address

3320 Sandy Way
Suite 4
South Lake Tahoe, CA 96150-8192
Phone (775) 450-8339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
46451CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284940800000",
    "number": "1861525628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 SANDY WAY",
            "address_2": "SUITE 4",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961508192",
            "telephone_number": "775-450-8339",
            "fax_number": "530-542-2791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 SANDY WAY",
            "address_2": "SUITE 4",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961508192",
            "telephone_number": "775-450-8339",
            "fax_number": "530-542-2791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "MONICA",
        "middle_name": "BARSON",
        "credential": "MFC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2010-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "46451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Lake Tahoe, CA

Sources for this page

Verify at the official NPI Registry.