Provider Demographics
NPI:1053514398
Name:CAMPION, SUSAN COLWELL (LMFT LADC)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:COLWELL
Last Name:CAMPION
Suffix:
Gender:F
Credentials:LMFT LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 MORRIS COVE RD
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06512-4017
Mailing Address - Country:US
Mailing Address - Phone:203-494-8148
Mailing Address - Fax:203-468-2139
Practice Address - Street 1:82 MORRIS COVE RD
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06512-4017
Practice Address - Country:US
Practice Address - Phone:203-494-8148
Practice Address - Fax:203-468-2139
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000752106H00000X
CT000369101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)