JACQUELINE MARIE CAMPBELL LMFT
NPI 1396490603
Counselor - Mental Health in Ooltewah, TN

Active since February 15, 2022Opted out of Medicare · through Feb 21, 2028
6011 CHESTERTON WAY STE 209, OOLTEWAH, TN 37363(423) 715-8099 Get Directions Write a Review

NPPES record last updated: December 12, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 12, 2023, Feb 15, 2022 (2 updates tracked since 2022).

About Jacqueline Marie Campbell Lmft NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACQUELINE MARIE CAMPBELL LMFT (NPI 1396490603) is an individual mental health provider in Ooltewah, Tennessee, licensed in Tennessee (1639) and active in the NPI registry since February 2022. She has opted out of Medicare through February 21, 2028.

NPPES Registry Identity

NPI1396490603
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameJACQUELINE MARIE CAMPBELLCredential: LMFT
Location Address6011 CHESTERTON WAY STE 209Ooltewah, TN 37363-1523
Mailing Address1455 19th St SeCleveland, TN 37311-7006 · (770) 608-8497
Sole ProprietorYes
Enumeration DateFebruary 15, 2022
Last NPPES UpdateDecember 12, 20232 updates tracked since enumeration
NPPES CertifiedDecember 12, 2023
NPI 1396490603 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License Licensed in TN · 1639
6011 CHESTERTON WAY STE 209, Ooltewah, TN 37363

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Jacqueline Marie Campbell Lmft has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 21, 2024 through February 21, 2028.

Opt-Out Effective DateFebruary 21, 2024
Opt-Out In Effect ThroughFebruary 21, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Chiropractor
6011 CHESTERTON WAY STE 209
OOLTEWAH, TN 37363
Psychologist (Clinical)
6011 CHESTERTON WAY STE 209
OOLTEWAH, TN 37363

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacqueline Campbell's NPI number?

The NPI number for Jacqueline Campbell is 1396490603. It was assigned to this individual provider in the NPPES registry on February 15, 2022.

Where is Jacqueline Campbell located?

Jacqueline Campbell practices at 6011 Chesterton Way Ste 209, Ooltewah, TN 37363. The listed phone number is (423) 715-8099.

What is Jacqueline Campbell's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Jacqueline Campbell enrolled in Medicare?

No. Jacqueline Campbell has opted out of Medicare through February 21, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jacqueline Campbell was last updated on December 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.