Family Service of Champaign County

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

FAMILY SERVICE OF CHAMPAIGN COUNTY

Practice address

405 S State St
Champaign, IL 61820-5129

Phone

(217) 352-0099

Fax

(217) 352-9512

NPI assigned

Mar 27, 2019

Organization subpart

Yes

Parent organization

FAMILY SERVICE OF CHAMPAIGN COUNTYAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Donna J Anglin

Title

Controller

Phone

(217) 352-0099

Specialties & licenses 1

Addresses

Part of

Family Service of Champaign County

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553644800000",
    "number": "1174084677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 S STATE ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618205129",
            "telephone_number": "217-352-0099",
            "fax_number": "217-352-9512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 S STATE ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618205129",
            "telephone_number": "217-352-0099",
            "fax_number": "217-352-9512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SERVICE OF CHAMPAIGN COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY SERVICE OF CHAMPAIGN COUNTY",
        "enumeration_date": "2019-03-27",
        "last_updated": "2019-03-27",
        "status": "A",
        "authorized_official_last_name": "ANGLIN",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "217-352-0099"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Fairchild, OT
• Briana Amaris Fairfield
• Mitzie Ralph Fairfield, NP
• Familia Dental Champaign LLC
• Familia First Health NFP
• Family Service of Champaign County
• Family Service of Champaign County
• Family Support & Training Center
• Duchelynn Fanfan
• Saba Farid, OD

• Mental Health Clinic/Center (Including Community Mental Health Center) in Champaign, IL
• Providers in Champaign, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.