Jacob Champney, MS LCMHC MLADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

884 Issued in NH

Practice address

100 Hitchcock Way
Dartmouth Hitchcock - Psychiatry
Manchester, NH 03104

Phone

(603) 650-6150

NPI assigned

Dec 19, 2006

Sex

Male

Sole proprietor

No

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 NH

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mary Hitchcock Memorial HospitalGroup PAC ID 4486561164, 1,269 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mary Hitchcock Memorial Hospital Hospital, Lebanon, NH, CCN 300003

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Mary Hitchcock Memorial Hospital

  • General Acute Care Hospital
  • Lebanon, NH
  • NPI 1023092053
  Medicare reassignment Care Compare group NPD
• Dartmouth-Hitchcock Clinic

  • Internal Medicine Physician
  • Lebanon, NH
  • NPI 1548210198
  Medicare reassignment NPD
• Dartmouth-Hitchcock Clinic

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Lebanon, NH
  • NPI 1124681846
  NPD
• Mary Hitchcock Memorial Hospital

  • General Acute Care Hospital
  • Lebanon, NH
  • NPI 1629788237
  NPD
• Mary Hitchcock Memorial Hospital

  • Psychiatric Hospital
  • Hampstead, NH
  • NPI 1699584219
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mary Hitchcock Memorial Hospital

  • General Acute Care Hospital
  • Lebanon, NH
  • NPI 1023092053
  Care Compare affiliation
• Mary Hitchcock Memorial Hospital

  • General Acute Care Hospital
  • Lebanon, NH
  • NPI 1629788237
  Care Compare affiliation

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540771200000",
    "number": "1730242876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HITCHCOCK WAY",
            "address_2": "DARTMOUTH HITCHCOCK - PSYCHIATRY",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "03104",
            "telephone_number": "603-650-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HITCHCOCK WAY",
            "address_2": "DARTMOUTH HITCHCOCK - PSYCHIATRY",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "03104",
            "telephone_number": "603-650-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPNEY",
        "first_name": "JACOB",
        "credential": "MS LCMHC MLADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2018-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NH",
            "license": "835",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NH",
            "license": "884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Chace
• Sylvie Jessie Chamberlin
• Nicole Chambers, LCMHC
• Valerie A Chames, RD, CDE
• Jeffrey D Champagne, OTRL
• Amit Chander, MD
• Theodore R Chandonnet Jr., MPT
• Visalakshi Chandramouleeswaran, OTR/L
• Jade Chandronnait, RN
• Amy Beth Chang, M.D.

• Mental Health Counselor in Manchester, NH
• Providers in Manchester, NH by specialty
• Mental Health Counselor in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; 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.