Sam Champagne

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P13515 Issued in NY

Practice address

3 Washington SQ Ste 3
Albany, NY 12205-5516

Phone

(518) 456-7501

NPI assigned

Oct 4, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Katie McLean Mental Health Counseling PLLCGroup PAC ID 7618328444, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Katie McLean Mental Health Counseling PLLC

  • Mental Health Counselor
  • Latham, NY
  • NPI 1619652039
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1093280299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 WASHINGTON SQ STE 3",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122055516",
            "telephone_number": "518-456-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 WASHINGTON SQ STE 3",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122055516",
            "telephone_number": "518-456-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPAGNE",
        "first_name": "SAM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-04",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P13515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Mercy Chamberlain
• Stephen M Chamberlin
• Kaylyn Chambers, MS CCC-SLP
• Mary E Chambers, M.S. CCC-SLP
• Yanique Chambers, LCSW
• Krystal Chan, MD
• Nicole Chan, DO
• Yvonne Chan, M.D.
• Randi Chancey, MA
• Anurag Chandra, M.D.

• Mental Health Counselor in Albany, NY
• Providers in Albany, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.