Individual
PROF. BENJAMIN JAMES LOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, LCSW
Contact information
Practice address
820 W COLUMBIA AVE, CHAMPAIGN, IL 61820-3306
(217) 721-5522
Mailing address
820 W COLUMBIA AVE, CHAMPAIGN, IL 61820-3306
(217) 721-5522
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.024787
IL
Other
Enumeration date
09/06/2022
Last updated
09/06/2022
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