Renee Costin Champagne-Davis, M.ED

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0704014828 Issued in VA

Practice address

364 McLaws Cir
Williamsburg, VA 23185-6340

Phone

(703) 939-5631

NPI assigned

Jun 1, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Abundant Life Partners LLCGroup PAC ID 6507142296, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

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.

• Abundant Life Partners, LLC

  • Clinical Social Worker
  • Williamsburg, VA
  • NPI 1942740279
  Medicare reassignment Care Compare group NPD
• Abundant Path LLC

  • Psychologist
  • Williamsburg, VA
  • NPI 1962374439
  NPD (past)

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1396484010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "364 MCLAWS CIR STE 2",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231856340",
            "telephone_number": "709-939-5631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "364 MCLAWS CIR",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231856340",
            "telephone_number": "703-939-5631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPAGNE-DAVIS",
        "first_name": "RENEE",
        "middle_name": "COSTIN",
        "credential": "M.ED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0704014828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.williamsburgyouthcounseling.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "364 McLaws Cir",
            "city": "Williamsburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "231856340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Danielle Cauley, LPC, CSAC
• Melinda Cave
• Shiny Kaithakuzhiyil Chacko
• Stephanie Chadwick, FNP-BC
• Emily Jones Chaikin, PA
• Allison Chaney
• Stacia L Chapman-Gorey, LCSW
• Jackson Layne Chappell, PHARMACIST
• Lakshmi R Chaudhuri, MD
• Brittany Gene Cheatham, OTD, OTR/L

• Mental Health Counselor in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.