Individual provider Active NPI

Todd Cole Campbell, PH.D.

  • Psychologist
  • Milwaukee, WI
National Provider Identifier
1871730242
Registry record updated Jan 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2158 Issued in WI
Practice address
561 N 15TH St
RM 150 Schroeder Complex Marquette University
Milwaukee, WI 53233-2237
Phone
(414) 288-5889
Fax
(414) 288-6100
NPI assigned
Jan 7, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2158 WI Primary

Addresses

Primary practice location

561 N 15TH St
RM 150 Schroeder Complex Marquette University
Milwaukee, WI 53233-2237

Mailing address

561 N 15TH St
RM 150 Schroeder Complex Marquette University
Milwaukee, WI 53233-2237
Phone (414) 288-5889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20110707000542 WI Practitioner - Clinical Psychologist 3779767249 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2158WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Waukesha County CurrentSince Jan 1, 2021 Accepting new patients
Cornerstone Counseling Services, Inc CurrentSince Jan 9, 2023 Accepting new patients
Waukesha County Current Accepting new patients
Waukesha County CurrentSince Jan 1, 2021 Accepting new patients
Behavioral Solutions, Inc. Psychologist CurrentSince May 1, 2022 Accepting new patients

Locations

16535 W Bluemound Rd
Ste 200
Brookfield, WI 53005
Phone (262) 789-0909

2115 E Woodstock Pl
Milwaukee, WI 53202
Phone (414) 271-1020

514 Riverview Ave
Waukesha, WI 53188
Phone (262) 548-7212

1501 Airport Rd
Waukesha, WI 53188
Phone (262) 548-7950

Organizations & group practices 5

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": "1231286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231286400000",
    "number": "1871730242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "561 N 15TH ST",
            "address_2": "RM 150 SCHROEDER COMPLEX MARQUETTE UNIVERSITY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332237",
            "telephone_number": "414-288-5889",
            "fax_number": "414-288-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 N 15TH ST",
            "address_2": "RM 150 SCHROEDER COMPLEX MARQUETTE UNIVERSITY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332237",
            "telephone_number": "414-288-5889",
            "fax_number": "414-288-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "TODD",
        "middle_name": "COLE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-07",
        "last_updated": "2009-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.