Individual
RICHARD F CHAMPOUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
(PMH) CNS - BC
Contact information
Practice address
151 SOUTH STREET, ASR, CUMMINGTON, MA 01026
(800) 258-1770
(413) 634-5379
Mailing address
PO BOX 3232, JABISH BROOK CONSULTING, AMHERST, MA 01004
(413) 262-5911
(815) 425-8877
Taxonomy
Speciality
Code
Description
License number
State
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
193661
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1892681
—
MA
01
—
PN0760
BLUE CROSS/BS
MA
Enumeration date
10/04/2005
Last updated
09/08/2008
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