Provider Demographics
NPI:1528165784
Name:CAMPION, MAUREEN (MS, LP)
Entity type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:
Last Name:CAMPION
Suffix:
Gender:F
Credentials:MS, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 AMERICAN BLVD E STE 102D
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55420-1301
Mailing Address - Country:US
Mailing Address - Phone:612-483-3487
Mailing Address - Fax:952-895-1946
Practice Address - Street 1:900 AMERICAN BLVD E STE 102D
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55420-1301
Practice Address - Country:US
Practice Address - Phone:612-483-3487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP4079103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN545326700Medicaid