Stephenie R Champlin, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW 74243 Issued in CA

Practice address

3505 Cadillac Ave
BLDG O, Suite 109
Costa Mesa, CA 92626-1429

Phone

(714) 432-9856

Fax

(714) 432-7075

NPI assigned

Jan 4, 2012

Last updated

Nov 18, 2016By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Clinical Social Worker

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Nancy D Young, PHD

  • Clinical Psychologist
  • Costa Mesa, CA
  • NPI 1205862224
  Medicare reassignment
• Nancy D Young PHD

  dba Pathways to Wellness

  • Clinical Psychologist
  • Costa Mesa, CA
  • NPI 1104029784
  Authorized official Same address or phone
• Pathways to Wellness

  • Community/Behavioral Health Agency
  • Costa Mesa, CA
  • NPI 1366984213
  NPD (past)

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

{
    "created_epoch": "1325635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479427200000",
    "number": "1710257936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 CADILLAC AVE",
            "address_2": "BLDG O, SUITE 109",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926261429",
            "telephone_number": "714-432-9856",
            "fax_number": "714-432-7075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 CADILLAC AVE",
            "address_2": "BLDG O, SUITE 109",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926261429",
            "telephone_number": "714-432-9856",
            "fax_number": "714-432-7075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPLIN",
        "first_name": "STEPHENIE",
        "middle_name": "R",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-04",
        "last_updated": "2016-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW 74243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Bruce Chaffee, RN
• Zela Jane Chahbazian, MA
• Priscilla Leane Chairoj, RN
• Jean Champion, MA, CCC-SLP
• Treavor Champion
• Courtney Paige Chan, RN
• Kayla Chan
• Marjorie M. Chan, NP
• Kevin Kethya Chanda
• Vidhi Chandnani

• Clinical Social Worker in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; 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.