Michael W. Champ, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

001546 Issued in IA

Practice address

200 W Lowe Ave
Suite 108
Fairfield, IA 52556-2470

Phone

(641) 233-8332

NPI assigned

Nov 9, 2012

Last updated

May 3, 2014By the provider in NPPES

Sex

Male

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

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

{
    "created_epoch": "1352419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399075200000",
    "number": "1356685580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W LOWE AVE",
            "address_2": "SUITE 108",
            "city": "FAIRFIELD",
            "state": "IA",
            "postal_code": "525562470",
            "telephone_number": "641-233-8332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W LOWE AVE",
            "address_2": "SUITE 108",
            "city": "FAIRFIELD",
            "state": "IA",
            "postal_code": "525562470",
            "telephone_number": "641-233-8332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMP",
        "first_name": "MICHAEL",
        "middle_name": "W.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-09",
        "last_updated": "2014-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "001546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Madison Buch, ARNP
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• Kristin Nicole Carr, P.T.A.
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• Sharon Rose Ciccone, LMT
• Clarity Speech Therapy, PLLC

• Mental Health Counselor in Fairfield, IA
• Providers in Fairfield, IA by specialty
• Mental Health Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.