Active NPI
Jennifer Luise Champagne, MA
- Professional Counselor
- Ansonia, CT
National Provider Identifier
1316001647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 000095
- Practice address
- 435 E Main St
Ansonia, CT 06401-1964 - Phone
- (203) 736-2601
- NPI assigned
- Dec 21, 2006
- Last updated
- Jun 9, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 000095 | CT | Primary |
Addresses
Primary practice location
435 E Main St
Ansonia, CT 06401-1964
Mailing address
27 Whipporwill Dr
Shelton, CT 06484-5900
Phone (203) 925-1428
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000095 | CT | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212969600000",
"number": "1316001647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27 WHIPPORWILL DR",
"city": "SHELTON",
"state": "CT",
"postal_code": "064845900",
"telephone_number": "203-925-1428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "435 E MAIN ST",
"city": "ANSONIA",
"state": "CT",
"postal_code": "064011964",
"telephone_number": "203-736-2601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAMPAGNE",
"first_name": "JENNIFER",
"middle_name": "LUISE",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-21",
"last_updated": "2008-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "000095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ansonia, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.