Shelby Champagne, MSW INTERN

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9709 Issued in CT

Practice address

1007 N Main St
Dayville, CT 06241-2170

Phone

(860) 774-2020

NPI assigned

Jun 25, 2014

Last updated

Feb 4, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: shelbyr.champagne@xdr.hhchealthdirect.org

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1114332434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 MANSFIELD AVE",
            "address_2": "YAS SUITE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "06226",
            "telephone_number": "860-456-2261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 N MAIN ST",
            "city": "DAYVILLE",
            "state": "CT",
            "postal_code": "062412170",
            "telephone_number": "860-774-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Myron St",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "West Springfield",
            "state": "MA",
            "postal_code": "010891598",
            "country_code": "US",
            "telephone_number": "413-592-1980",
            "fax_number": "413-439-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAMPAGNE",
        "first_name": "SHELBY",
        "credential": "MSW INTERN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-25",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "9709",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Care Counseling Center LLC
• Daniel Carini
• Christopher George Carnaroli, PHARMD, RPH
• David Marc Caron, DMD
• Yoel Carrasquillo Vega, M.D.
• Celeste R. Chartier, LPC
• Amaryllis Chaves
• Amanda Cicchetti, LPC-A
• Kaylyn Clark, PHARMD, RPH
• Christopher John Colby, MA

• Clinical Social Worker in Dayville, CT
• Providers in Dayville, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.