KELLY MICHELLE CAMPBELL (LCSW) – Clinical Social Worker, NPI 1669763090

KELLY MICHELLE CAMPBELL (LCSW) is a healthcare provider. based in North las vegas, Nevada. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 6917-C (NV). The NPI Number for KELLY MICHELLE CAMPBELL (LCSW) is 1669763090

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
KELLY MICHELLE CAMPBELL (LCSW)
NPI
1669763090
Phone
(702) 858-9086
Address
204 TOASTED ALMOND AVE
Enumeration Date
19 April 2011
Last Update Date
16 December 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7029350025
Graduation Year
2012 (14 years ago)
PAC ID
5496933285
Group Practice PAC ID
4981969771
Professional Enrollment ID
I20151021001477
Address ID
NV891465625LA2780XBLVD400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:15State licenses:1Digital endpointsOther names

548 CLINICAL SOCIAL WORKER in NV

Provider Addresses for KELLY MICHELLE CAMPBELL (LCSW)

  • 204 TOASTED ALMOND AVE

    NORTH LAS VEGAS, NV 890841326

    Phone: (702) 858-9086

    Type: Mailing

  • 2780 S JONES BLVD STE 100A

    LAS VEGAS, NV 891465625

    Phone: (702) 820-3061

    Fax: (702) 935-0008

    Type: Mailing

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: 2015-10-21

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
I20151021001477IClinical Social WorkerNVTBD

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 89084)

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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: 4981969771View full group profile
NameSpecialtyState
Clinical Social WorkerNV
Marriage And Family TherapistNV
Clinical Social WorkerNV
Marriage And Family TherapistNV
Mental Health CounselorNV
-NV
Clinical Social WorkerNV
Clinical Social WorkerNV
-VT
-NV

Reviews

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Frequently asked questions

Can I use this page to confirm KELLY MICHELLE CAMPBELL (LCSW)'s NPI?
Yes. KELLY MICHELLE CAMPBELL (LCSW) is listed with NPI 1669763090 in the public NPI dataset.
Is KELLY MICHELLE CAMPBELL (LCSW) listed as active for patients and plans?
The listing shows KELLY MICHELLE CAMPBELL (LCSW) as active in the NPI system.
What taxonomy line describes KELLY MICHELLE CAMPBELL (LCSW)?
For research purposes, treat KELLY MICHELLE CAMPBELL (LCSW) as Clinical Social Worker in this dataset. Clinical services aligned with this taxonomy classification.
Does KELLY MICHELLE CAMPBELL (LCSW) list a practice location?
Patients near North Las Vegas, Nevada may find KELLY MICHELLE CAMPBELL (LCSW) in results; validate coverage separately.
How many locations tie to this NPI?
4 practice locations appear in the available data.

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