Provider Demographics
NPI:1740958396
Name:ORMOND, CHAMPAIN
Entity type:Individual
Prefix:
First Name:CHAMPAIN
Middle Name:
Last Name:ORMOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 HERRINGTON BEND RD NW APT 12
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-7957
Mailing Address - Country:US
Mailing Address - Phone:970-620-5665
Mailing Address - Fax:
Practice Address - Street 1:4083 CLOUD SPRINGS RD
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-8411
Practice Address - Country:US
Practice Address - Phone:706-820-6087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)