WILLIE LARRY CAMPBELL (LMSW) – Clinical Social Worker, NPI 1467691907

WILLIE LARRY CAMPBELL (LMSW) is a healthcare provider. based in Vicksburg, Michigan. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LMSW. They hold a License No. 6801035436 (MI). The NPI Number for WILLIE LARRY CAMPBELL (LMSW) is 1467691907

Main info

Male
Sole Proprietor
39 Years Of Experience
Accepts Medicare Assignment
Name
WILLIE LARRY CAMPBELL (LMSW)
NPI
1467691907
Phone
(248) 202-7919
Address
11266 E INDIAN LAKE DR
Enumeration Date
6 February 2009
Last Update Date
1 May 2020

Doctor Profile

Medical School Name
UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Secondary Phone
2489733660
Graduation Year
1987 (39 years ago)
PAC ID
8729419841
Group Practice PAC ID
1850516758
Professional Enrollment ID
I20200505002126
Address ID
MI48393XXXXWIXXXXXXXXXX00
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience58
Completeness75
Years active:17State licenses:1Digital endpointsOther names

4,821 CLINICAL SOCIAL WORKER in MI

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Provider Addresses for WILLIE LARRY CAMPBELL (LMSW)

  • 11266 E INDIAN LAKE DR

    VICKSBURG, MI 490979560

    Phone: (248) 202-7919

    Type: Mailing

  • 3800, Lakeland Lane, Island Lake Woods, Bloomfield Hills, Oakland County, Michigan, 48302, United States

    BLOOMFIELD HILLS, MI 483021327

    Phone: (248) 973-3660

    Fax: (248) 973-3662

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-05-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200505002126IClinical Social WorkerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49097)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1850516758View full group profile
NameSpecialtyState
D E R M A T O L O G YMI
Psychiatry, Addiction MedicineMI
Internal MedicineMI
-MI
Physician AssistantFL
Preventive Medicine, Internal MedicineMI

Reviews

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Frequently asked questions

Does WILLIE LARRY CAMPBELL (LMSW) have a public NPI I can cite?
Public records show WILLIE LARRY CAMPBELL (LMSW) under NPI 1467691907.
Is WILLIE LARRY CAMPBELL (LMSW)'s NPI status active today?
Active status means WILLIE LARRY CAMPBELL (LMSW)'s NPI record is not deactivated in the public file.
What services align with WILLIE LARRY CAMPBELL (LMSW)'s listing?
WILLIE LARRY CAMPBELL (LMSW)'s public classification highlights Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What geographic area is tied to WILLIE LARRY CAMPBELL (LMSW)?
WILLIE LARRY CAMPBELL (LMSW) is associated with Vicksburg, Michigan in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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