Carrie Champion, LCDC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

81264 Issued in TX

Practice address

24303 W Oak Dr
Porter, TX 77365-5673

Phone

(615) 906-4166

NPI assigned

Nov 18, 2020

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

Other names 1

• Carrie Rosberg Former name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Deer Oaks Geriatric Services P C

  • Clinical Psychologist
  • San Antonio, TX
  • NPI 1134169287
  Medicare reassignment NPD
• Vcounselors PLLC

  • Professional Counselor
  • San Antonio, TX
  • NPI 1326784307
  NPD
• Deer Oaks Mental Health Associates PC

  • Clinical Psychologist
  • Las Cruces, NM
  • NPI 1134175763
  NPD (past)

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1316540883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24303 W OAK DR",
            "city": "PORTER",
            "state": "TX",
            "postal_code": "773655673",
            "telephone_number": "615-906-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24303 W OAK DR",
            "city": "PORTER",
            "state": "TX",
            "postal_code": "773655673",
            "telephone_number": "615-906-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPION",
        "first_name": "CARRIE",
        "credential": "LCDC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-18",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "13825",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "81264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "ROSBERG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Asia Mekell Brumfield, LCSW
• Cory Khoiquoc Tuong Bui, M.D
• Tanile Burns
• Kimberly Burr
• Angelo Cediel
• Karina Chapa
• Lisa M Chapman, QMHP-CS
• Matthew Cheramie, PHARMD
• Robert Cheruiyot
• Teressa F Chustz, PT

• Professional Counselor in Porter, TX
• Providers in Porter, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.