Andre Gregrolle John Campbell, M.A.,LMFT.LADC.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

997 Issued in OK

Practice address

2510 East 15TH Street
Suite 205
Tulsa, OK 74104

Phone

(918) 508-2750

Fax

(918) 744-4432

NPI assigned

Jul 1, 2009

Last updated

Jul 19, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1871721555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 E. 15TH ST.",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74104",
            "telephone_number": "918-508-2750",
            "fax_number": "918-744-4432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 EAST 15TH STREET",
            "address_2": "SUITE 205",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74104",
            "telephone_number": "918-508-2750",
            "fax_number": "918-744-4432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "ANDRE",
        "middle_name": "GREGROLLE JOHN",
        "name_prefix": "Mr.",
        "credential": "M.A.,LMFT.LADC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-01",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OK",
            "license": "968",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OK",
            "license": "997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manuel Rolando Campa-Moreno Jr.
• Shari Lyn Campanell, P.T.
• Sierra Taylor Campbell-Voges
• Allyson Michelle Campbell, PA-C
• Amy Marie Campbell, PA
• Ann Elaine Campbell, M.D.
• Bre Campbell
• Candace L. Campbell, APRN-CNP
• Christopher Andrew Campbell, CSFA
• David Paul Campbell, D.O.

• Marriage & Family Therapist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Marriage & Family Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; 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.