Champion, Connie Rae

Champion, Connie Rae is an individual health care provider with primary practice located at 414 Broadway St Ste 101 , Baraboo WI 53913-2488. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Champion, Connie Rae can be contacted via phone (608) 402-4312.

Contact Information

Primary practice address
414 Broadway St Ste 101 Baraboo WI 53913-2488
Phone: (608) 402-4312
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 3265 Wisconsin
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 18546 Wisconsin

Profile Details

NPI number 1598253890
LBN Legal business name Champion, Connie Rae
Credentials LSW, LPC-IT, SAC-IT
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 23rd, 2018
Last updated Apr 23rd, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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