Fay Lucille Champoux, L.I.C.S.W

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

111365 Issued in MA

Practice address

1415 Beacon St.,
Boston Institute for Psychotherapy Suite 120
Brookline, MA 02446

Phone

(617) 566-2200

NPI assigned

Aug 3, 2012

Last updated

Aug 20, 2012By 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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1343952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345420800000",
    "number": "1326394750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 TREEHOUSE CIR",
            "address_2": "APARTMENT 3",
            "city": "EASTHAMPTON",
            "state": "MA",
            "postal_code": "010272175",
            "telephone_number": "413-459-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 BEACON ST.,",
            "address_2": "BOSTON INSTITUTE FOR PSYCHOTHERAPY SUITE 120",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "02446",
            "telephone_number": "617-566-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPOUX",
        "first_name": "FAY",
        "middle_name": "LUCILLE",
        "name_prefix": "Ms.",
        "credential": "L.I.C.S.W",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-03",
        "last_updated": "2012-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "111365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Jane Cerrone, LMHC
• Sophia Cha
• Susan Jacqueline Chamandy, LICSW
• Deborah Chamberlain, LMHC
• Chantal Chammas, DMD
• Hannah Chan
• Hui-Chu Julia Chang, O.D., PH.D
• Rhona Chang
• Allison Chann, LMHC
• David S Chapin, M.D.

• Clinical Social Worker in Brookline, MA
• Providers in Brookline, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2012; 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.