MR. WILLIE JAMES CAMPBELL SR. (NPI# 1417217092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417217092 |
| Entity Type | Individual |
| Full Name | MR. WILLIE JAMES CAMPBELL SR. |
| Credential | LCSW |
| Practice Address |
101 Devant St Suite 606 Fayetteville GA 30214-2710 |
| Mailing Address |
Po Box 709 Fairburn GA 30213-0709 |
| Practice Telephone | 7709692569 |
| Mailing Telephone | 7709692569 |
| Enumeration Date | 2012-05-17 |
| Last Update Date | 2019-05-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
CSW004685 | GA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1345 Redmond Cir Nw, Rome, GA 301651307 | 9107429243 | 8887461787 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124532296 | Willie Campbell Jr. | Psychologist | 5575 Conner St, Detroit, MI 48213-6400 | 2017-11-27 |
| 1467691907 | Willie Larry Campbell | Social Worker | 3800 Lakeland Ln, Bloomfield Hills, MI 48302-1327 | 2009-02-06 |
| Street Address |
101 DEVANT ST SUITE 606 |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-2710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689676157 | Ginari Gibb Price | Psychiatry & Neurology | 101 Devant St, Ste 504, Fayetteville, GA 30214 | 2005-08-13 |
| 1972018117 | Natalie Bernett Bonner | Nurse Practitioner | 101 Devant St, Fayetteville, GA 30214-2710 | 2017-12-11 |
| 1447638945 | Natalie Generally | Music Therapist | 101 Devant St, Suite 703, Fayetteville, GA 30214-2710 | 2015-05-15 |
| 1174901672 | Small Steps Music, L.L.C. | Music Therapist | 101 Devant St, Suite 703, Fayetteville, GA 30214-2710 | 2015-05-15 |
| 1578827606 | The Progressive Counseling and Therapy Center, LLC | Community/Behavioral Health | 101 Devant St, Suite 606, Fayetteville, GA 30214-2710 | 2012-07-04 |
| 1144593021 | Living Well Primary Care, LLC | Family Medicine | 101 Devant St, Suite 902, Fayetteville, GA 30214-2710 | 2012-02-22 |
| 1053683359 | North Fayette Family Practice | Family Medicine | 101 Devant St, Suite 902, Fayetteville, GA 30214-2710 | 2012-02-01 |
| 1073884482 | Agape Speech Therapy, LLC | Speech-Language Pathologist | 101 Devant St, Suite 703, Fayetteville, GA 30214-2710 | 2012-01-17 |
| 1033405659 | Linda H Radcliffe | Speech-Language Pathologist | 101 Devant St, Suite 703, Fayetteville, GA 30214-2710 | 2011-06-22 |
| 1710270343 | Williams Medical, Inc. | Clinic/Center | 101 Devant St, Suite 903, Fayetteville, GA 30214-2710 | 2011-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700484201 | Torrie Luciana Powell | Social Worker | 3526 Standard Dr, Fayetteville, NC 28306-8089 | 2020-10-15 |
| 1053918169 | Activelife Counseling, LLC | Social Worker | 1792 E Joyce Blvd Ste 105, Fayetteville, AR 72703-5253 | 2020-10-02 |
| 1861004996 | Roderick Eugene Brown Jr. | Social Worker | 2014 Litho Pl Ste 200, Fayetteville, NC 28304-2518 | 2020-08-19 |
| 1427667278 | Valerie Russell | Social Worker | 6209 Lakehaven Dr, Fayetteville, NC 28304-0610 | 2020-07-28 |
| 1942822671 | Alexis Oneal Vestal | Social Worker | 723 Athens Ave, Fayetteville, NC 28301-4800 | 2020-05-15 |
| 1346862281 | Heather Marie Sroka | Social Worker | 690 N Reilly Rd # F, Fayetteville, NC 28303-5724 | 2020-05-14 |
| 1952920449 | Vonetta Bethea Jackson | Social Worker | 391 Wagoner Drive, Fayetteville, NC 28303 | 2020-04-14 |
| 1730716887 | Denise Rodriguez | Social Worker | 2885 N Brookbury Xing, Fayetteville, AR 72703-4377 | 2020-03-26 |
| 1982239877 | Alicia Story | Social Worker | 3035 Boone Trail Ext, Fayetteville, NC 28304-3992 | 2020-03-11 |
| 1053959619 | Benlyd Colon | Social Worker | 2940 Breezewood Ave Ste 101-201, Fayetteville, NC 28303-5520 | 2019-12-13 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
Please comment or provide details below to improve the information on MR. WILLIE JAMES CAMPBELL SR..
| 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.