Elise Noelle Champanhet

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

2207 Woodhavens Dr
Bloomington, IL 61701-7812

Phone

(312) 561-6289

NPI assigned

Jun 5, 2019

Last updated

May 16, 2024By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 4, 2026 through Apr 4, 2028

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

• Optimum Joy, P.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1053825380

  Professional

  NPD (past)

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1154989069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6324 GREENLAND RD",
            "city": "UNION",
            "state": "KY",
            "postal_code": "410913402",
            "telephone_number": "989-600-4610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2207 WOODHAVENS DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617017812",
            "telephone_number": "312-561-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPANHET",
        "first_name": "ELISE",
        "middle_name": "NOELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vicken S Chalian, M.D.
• Autumn Chall
• Stacy Chalmers, MS CCCA
• C. Elizabeth Chamberlain-Lane, SLP
• Diane Chamberlin, B.S.
• Champion Fitness, Inc
• Jamie Elizabeth Champion
• Champions Heart Oasis LLC
• Bruce Chandler, MD
• Payton Chandler, SLP

• Professional Counselor in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.