Individual
MS. CHERYL CHAMPION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1930 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-4708
(763) 427-7964
(763) 427-7976
Mailing address
1930 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-4708
(763) 427-7964
(763) 427-7976
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11195
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265575542
BLUE CROSS BLUE SHIELD OF MINNESOTA
MN
05
—
1265575542
—
MN
Enumeration date
02/15/2007
Last updated
04/07/2009
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