Elvin Emanuel Campbell, BA, BSW, AAS, PRSS

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

1514 Kanawha Blvd W
Charleston, WV 25387-2533

Phone

(304) 610-9964

Fax

(304) 768-7647

NPI assigned

Dec 21, 2022

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Associate of Applied Science, Bachelor of Arts

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.

• Partnership of African American Churches Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Charleston, WV
  • NPI 1679060420
  NPD
• Patrtnership of African American Churches

  • Professional Counselor
  • Charleston, WV
  • NPI 1346734803

  Peer Specialist

  NPD (past)

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

{
    "created_epoch": "1671580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1982316915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 KANAWHA BLVD W",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253872533",
            "telephone_number": "304-610-9964",
            "fax_number": "304-768-7647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 KANAWHA BLVD W",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253872533",
            "telephone_number": "304-610-9964",
            "fax_number": "304-768-7647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "ELVIN",
        "middle_name": "EMANUEL",
        "credential": "BA, BSW, AAS, PRSS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-21",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175T00000X",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Campbell, MSN, FNP-BC
• Ashley Campbell
• Christopher Ryan Campbell, CNP
• Cora Michelle Campbell, CRNA
• Crystal Campbell, RN
• Jacqueline Campbell
• James Campbell, M.D.
• John E Campbell, MD
• Krista Kay Campbell, FNP-BC
• Latonya Campbell

• Peer Specialist in Charleston, WV
• Providers in Charleston, WV by specialty
• Peer Specialist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; 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.