Shareen Nicole Campbell, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R196504 Issued in MD

Practice address

20 Paula PL
Rosedale, MD 21237-4547

Phone

(443) 680-0361

NPI assigned

Mar 4, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Divine Counseling LLC

  • Clinical Social Worker
  • Owings Mills, MD
  • NPI 1184291155

  Single Specialty

  Medicare reassignment NPD
• Divine Counseling LLC

  • Community/Behavioral Health Agency
  • Owings Mills, MD
  • NPI 1407537186
  NPD
• Mercy Ijoma-Family Health Connections

  • Primary Care Clinic/Center
  • Ellicott City, MD
  • NPI 1598203812
  NPD

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

{
    "created_epoch": "1614816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1982299632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9055 CHEVROLET DR STE 205",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210424000",
            "telephone_number": "410-465-5451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PAULA PL",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212374547",
            "telephone_number": "443-680-0361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "SHAREEN",
        "middle_name": "NICOLE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-04",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R196504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenyon Bush, PHARMD
• Marilyn Calderon
• Julianne Wilkens Calhoun, RDN
• Lauren Callas
• Jessica Calle, LCSW-C
• Katharine Campos, LMSW
• Brock Carder, LGPC
• Carebridge Primary and Urgent Care LLC
• Joanne Stacey A Carillo
• Caring Home Care LLC

• Psychiatric/Mental Health Nurse Practitioner in Rosedale, MD
• Providers in Rosedale, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.