Elaine Potter Champion, LPC, CSAC, CRC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701005122 Issued in VA

Practice address

1241 Mall Dr
North Chesterfield, VA 23235-4879

Phone

(804) 310-7620

Fax

(804) 421-7127

NPI assigned

Jan 14, 2014

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1389657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389657600000",
    "number": "1144642984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 CEDAR HOLLOW CT",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232383441",
            "telephone_number": "804-310-7620",
            "fax_number": "804-421-7127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241 MALL DR",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232354879",
            "telephone_number": "804-310-7620",
            "fax_number": "804-421-7127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPION",
        "first_name": "ELAINE",
        "middle_name": "POTTER",
        "name_prefix": "Ms.",
        "credential": "LPC, CSAC, CRC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-14",
        "last_updated": "2014-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0710101850",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701005122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in North Chesterfield, VA
• Providers in North Chesterfield, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2014; 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.