Provider Demographics
NPI:1902952955
Name:CHAMPALOUX, BARBARA R (LCSW C)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:R
Last Name:CHAMPALOUX
Suffix:
Gender:F
Credentials:LCSW C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4807 MONROVIA CT
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:MD
Mailing Address - Zip Code:21770-6086
Mailing Address - Country:US
Mailing Address - Phone:301-455-5108
Mailing Address - Fax:
Practice Address - Street 1:4807 MONROVIA CT
Practice Address - Street 2:
Practice Address - City:MONROVIA
Practice Address - State:MD
Practice Address - Zip Code:21770-6086
Practice Address - Country:US
Practice Address - Phone:301-262-6799
Practice Address - Fax:301-299-4731
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD028571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CH663808Medicare ID - Type Unspecified