Individual provider Active NPI

Mary Beth Campbell, LCSW

  • Clinical Social Worker
  • Clayton, NC
National Provider Identifier
1871035741
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C010031 Issued in NC
Practice address
105 S Ellington St
Clayton, NC 27520-2305
Phone
(919) 243-0454
Fax
(919) 243-0923
NPI assigned
Nov 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C010031 NC Primary

Addresses

Primary practice location

105 S Ellington St
Clayton, NC 27520-2305

Mailing address

2000 Perimeter Park Dr Ste 200
Morrisville, NC 27560-8442

Other practice location 1

34 Healthpark Way Ste 100
Clayton, NC 27520-4497
Phone (919) 585-8850

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mcampbell691470@direct.UNC.nchie.net Direct
Direct Messaging Address mcampbell691470@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20170222001927 NC Practitioner - Clinical Social Worker 1052695855 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C010031NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Unc Physicians Network LLC Current Accepting new patients
University of North Carolina at Chapel Hill CurrentSince Jul 8, 2022 Accepting new patients
Unc Physicians Network LLC CurrentSince Mar 22, 2021 Accepting new patients
University of North Carolina at Chapel Hill CurrentSince Jul 8, 2022 Accepting new patients
Unc Physicians Network LLC CurrentSince Mar 22, 2021 Accepting new patients
Psychological Mobile Services Past Accepting new patients

Locations

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123

100 Eastowne Dr
Fl 14
Chapel Hill, NC 27514
Phone (984) 215-5556

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

100 Eastowne Dr
Fl 56
Chapel Hill, NC 27514
Phone (984) 215-5556

34 Healthpark Way
Ste 100
Clayton, NC 27520
Phone (919) 585-8850

2000 Perimeter Park Dr
Ste 200
Morrisville, NC 27560
Phone (800) 594-8624

Interoperability endpoints

  • Direct secure messaging: mcampbell691470@direct.unc.nchie.net

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1478649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1871035741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PERIMETER PARK DR STE 200",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275608442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S ELLINGTON ST",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275202305",
            "telephone_number": "919-243-0454",
            "fax_number": "919-243-0923"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34 Healthpark Way Ste 100",
            "address_purpose": "LOCATION",
            "city": "Clayton",
            "state": "NC",
            "postal_code": "275204497",
            "country_code": "US",
            "telephone_number": "919-585-8850",
            "fax_number": "919-585-8869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "MARY",
        "middle_name": "BETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-09",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C010031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcampbell691470@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "34 Healthpark Way Ste 100",
            "city": "Clayton",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275204497",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcampbell691470@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "101 Manning Dr",
            "city": "Chapel Hill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275144220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

Verify at the official NPI Registry.