Provider Demographics
NPI:1972662997
Name:CAMPION, BARROW AND ASSOCIATES
Entity Type:Organization
Organization Name:CAMPION, BARROW AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RITTENHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-356-9922
Mailing Address - Street 1:2110 CLEARLAKE BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61822-8931
Mailing Address - Country:US
Mailing Address - Phone:217-356-9922
Mailing Address - Fax:217-356-9875
Practice Address - Street 1:2110 CLEARLAKE BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61822-8931
Practice Address - Country:US
Practice Address - Phone:217-356-9922
Practice Address - Fax:217-356-9875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL71001608101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5872001OtherBLUE CROSS PROVIDER