MR. WILLIE CAMPBELL JR. (NPI# 1124532296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124532296 |
| Entity Type | Individual |
| Full Name | MR. WILLIE CAMPBELL JR. |
| Credential | MS TLLP |
| Practice Address |
5575 Conner St Detroit MI 48213-6400 |
| Mailing Address |
21575 Duns Scotus St Southfield MI 48075-3226 |
| Practice Telephone | 3136435542 |
| Practice Fax Number | 2485227045 |
| Mailing Telephone | 3135959039 |
| Enumeration Date | 2017-11-27 |
| Last Update Date | 2017-11-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
6301016973 | MI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 6301016973 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417217092 | Willie James Campbell Sr. | Social Worker | 101 Devant St, Suite 606, Fayetteville, GA 30214-2710 | 2012-05-17 |
| 1467691907 | Willie Larry Campbell | Social Worker | 3800 Lakeland Ln, Bloomfield Hills, MI 48302-1327 | 2009-02-06 |
| Street Address |
5575 CONNER ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48213-6400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821027756 | Jacqueline Phillips Dpm Inc | Durable Medical Equipment & Medical Supplies | 5575 Conner St, Suite 203, Detroit, MI 48213-6400 | 2006-07-02 |
| 1689293458 | World Wide Clinical Labz LLC | Clinical Medical Laboratory | 5575 Conner St, Detroit, MI 48213-6400 | 2020-04-13 |
| 1295361004 | Angela Colette Walker-tolbert | Counselor | 5575 Conner St, Detroit, MI 48213-6400 | 2020-03-13 |
| 1881053874 | Theyazan Kohaif | Social Worker | 5575 Conner St, Detroit, MI 48213-6400 | 2016-02-18 |
| 1295123180 | Phillips Foot Clinic | Podiatrist | 5575 Conner St, Suite 203, Detroit, MI 48213-6400 | 2014-12-31 |
| 1578976437 | Seton Health Corporation of Southeastern Michigan | Clinic/Center | 5575 Conner St, Detroit, MI 48213-6400 | 2014-06-09 |
| 1386060127 | John Evans | Counselor | 5575 Conner St, Suite 201 Pavilion Building, Detroit, MI 48213-6400 | 2014-03-17 |
| 1720424013 | Samaritan Urgent Care PC | Clinic/Center | 5575 Conner St, Detroit, MI 48213-6400 | 2013-05-14 |
| 1912343203 | Samaritan Urgent Care PC | Internal Medicine | 5575 Conner St, Detroit, MI 48213-6400 | 2013-05-14 |
| 1750657821 | Jacqueline Phillips Dpm Inc | Durable Medical Equipment & Medical Supplies | 5575 Conner St, Suite 203, Detroit, MI 48213-6400 | 2012-03-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215540430 | Sheronda Lanetta Blackmon | Licensed Practical Nurse | 13929 Harper Ave., Detroit, MI 48213 | 2020-08-27 |
| 1073049144 | Cheryl Williams | Community Health Worker | 13929 Chalmers Ave., Detroit, MI 48213 | 2017-05-10 |
| 1164963401 | Smile Fresh Detroit PC | Dentist | 7230 Gratiot Avenue, Detroit, MI 48213 | 2017-03-20 |
| 1255887899 | Jay Washington | Behavioral Analyst | 9146 Haper, Detroit, MI 48213 | 2016-09-01 |
| 1396129532 | Sarietha King | Home Health | 14639 Manistique, Detroit, MI 48213 | 2015-07-17 |
| 1366823197 | Royal Treatment Mental Health Systems, LLC | Counselor | 5555 Corner Avenue, Detroit, MI 48213 | 2015-06-17 |
| 1477956779 | Monique Powell | Student in an Organized Health Care Education/Training Program | 5801 Lakeview S.t, Detroit, MI 48213 | 2014-09-30 |
| 1629339163 | Samuel Joseph Farmer | Counselor | 10100 Harper Ave., Detroit, MI 48213 | 2012-05-31 |
| 1609164755 | Vernon Keith Johnson | Social Worker | 20203 Kelly Road, Detroit, MI 48213 | 2011-07-11 |
| 1023312790 | Davenport Quality Home Care LLC | Home Health | 5027 Maxwell, Detroit, MI 48213 | 2011-01-10 |
| Find all providers in zip 48213 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528675568 | Andria Lynn Norman | Psychologist | 71 Garfield St Apt 270, Detroit, MI 48201-1907 | 2020-09-24 |
| 1639793011 | Lori Hale | Psychologist | 1071 W Lantz St, Detroit, MI 48203-5100 | 2020-06-02 |
| 1043728819 | Sami Farhat | Psychologist | 1025 E Forest Ave Bldg C, Detroit, MI 48207-1024 | 2018-01-16 |
| 1235644469 | Denise Elizabeth Wallace | Psychologist | 7310 Woodward Ave Ste 401, Detroit, MI 48202-3165 | 2017-12-11 |
| 1669843850 | Amyna Ftouni | Psychologist | 553 E Jefferson Ave, Detroit, MI 48226-4324 | 2015-10-13 |
| 1326424078 | Wendy Pandora Cody | Psychologist | 11253 Somerset Ave, Detroit, MI 48224-1128 | 2015-08-05 |
| 1629475199 | Renee Bouey | Psychologist | 18480 Lancashire St, Detroit, MI 48223-1325 | 2014-11-29 |
| 1649697343 | Shelby Wilson-drummond | Psychologist | 70 W Alexandrine St, Detroit, MI 48201-2051 | 2014-03-20 |
| 1184068975 | Shara L. Johnson | Psychologist | 19511 Greenfield Rd, Detroit, MI 48235-2016 | 2013-04-23 |
| 1649511015 | Lindsay Yeager Carr | Psychologist | 2629 Lenox St, Detroit, MI 48215-2667 | 2013-03-11 |
| Find all providers in DETROIT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.