Provider Demographics
NPI:1922270826
Name:CHAMPAGNE, RHONDA LEE (LCSW)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:LEE
Last Name:CHAMPAGNE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3595 PINE HILLS DR
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-6411
Mailing Address - Country:US
Mailing Address - Phone:406-459-2021
Mailing Address - Fax:
Practice Address - Street 1:3595 PINE HILLS DR
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59602-6411
Practice Address - Country:US
Practice Address - Phone:406-459-2021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-31
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTP00692139 C01340OtherRAILROAD MEDICARE
MT0000070666OtherBLUE CROSS-SHIELD OF MONTANA
MT011001508Medicare PIN