Individual provider Active NPI

Cheryl Ann Champagne, MS

  • Mental Health Counselor
  • New Port Richey, FL
National Provider Identifier
1396411062
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
22043 Issued in FL
Practice address
7623 Little Rd Ste 300-325B
New Port Richey, FL 34654-5570
Phone
(727) 910-5990
NPI assigned
Aug 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 22043 FL Primary

Addresses

Primary practice location

7623 Little Rd Ste 300-325B
New Port Richey, FL 34654-5570

Mailing address

36750 US Highway 19 N
Palm Harbor, FL 34684-1239
Phone (917) 361-7201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20231215000038 FL Practitioner - Mental Health Counselor 7618326638 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
22043FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bonita Springs Retirement Village, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Dna Comprehensive Therapy Services, LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Hyde Psychological Services LLC CurrentSince Mar 10, 2025 Accepting new patients

Locations

4310 Metro Pkwy
Ste 205
Fort Myers, FL 33916

7623 Little Rd
Ste 300B
New Port Richey, FL 34654
Phone (727) 910-5990

1150 Tampa Rd
Palm Harbor, FL 34683
Phone (727) 469-3008

3191 Harbor Blvd
Ste A
Pt Charlotte, FL 33952
Phone (941) 766-9555

5825 Argerian Dr
Ste 101
Wesley Chapel, FL 33545
Phone (813) 687-4870

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1629504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1396411062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36750 US HIGHWAY 19 N",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346841239",
            "telephone_number": "917-361-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7623 LITTLE RD STE 300-325B",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346545570",
            "telephone_number": "727-910-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPAGNE",
        "first_name": "CHERYL",
        "middle_name": "ANN",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-21",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "22043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Port Richey, FL

Sources for this page

Verify at the official NPI Registry.