Jessica Champagne LCSW LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9924 Issued in CT

Legal business name

JESSICA CHAMPAGNE LCSW LLC

Practice address

12 Wilson Dr
Oxford, CT 06478-1422

Phone

(860) 468-9088

NPI assigned

Jul 31, 2018

Last updated

Feb 19, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Jessica Champagne, LCSWNPI 1225444722

Title

Psychotherapist

Phone

(203) 543-3307

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jessica Champagne, LCSW

  • Social Worker
  • Oxford, CT
  • NPI 1225444722
  NPD Authorized official

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613692800000",
    "number": "1124506266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 WILSON DR",
            "city": "OXFORD",
            "state": "CT",
            "postal_code": "064781422",
            "telephone_number": "860-468-9088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 WILSON DR",
            "city": "OXFORD",
            "state": "CT",
            "postal_code": "064781422",
            "telephone_number": "860-468-9088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "43 Sherman Hill Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "CT",
            "postal_code": "067983651",
            "country_code": "US",
            "telephone_number": "203-543-3307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JESSICA CHAMPAGNE LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-31",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A",
        "authorized_official_last_name": "CHAMPAGNE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "203-543-3307",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "9924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Arifa Khan

• Clinical Social Worker in Oxford, CT
• Providers in Oxford, 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 19, 2021; 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.