Active NPI
Jan Champion, LMSW, ACSW
- Mental Health Counselor
- Royal Oak, MI
National Provider Identifier
1750416368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 680104643
- Practice address
- 217 Knowles St
Suite 140
Royal Oak, MI 48067-2767 - Phone
- (248) 542-3446
- Fax
- (248) 677-3978
- NPI assigned
- Feb 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 680104643 | MI | Primary |
Addresses
Primary practice location
217 Knowles St
Suite 140
Royal Oak, MI 48067-2767
Mailing address
217 Knowles St
Royal Oak, MI 48067-2767
Phone (248) 542-3446
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 680104643 | MI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432080000000",
"number": "1750416368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "217 KNOWLES ST",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480672767",
"telephone_number": "248-542-3446",
"fax_number": "248-589-1765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "217 KNOWLES ST",
"address_2": "SUITE 140",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480672767",
"telephone_number": "248-542-3446",
"fax_number": "248-677-3978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAMPION",
"first_name": "JAN",
"credential": "LMSW, ACSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-22",
"last_updated": "2015-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MI",
"license": "680104643",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Royal Oak, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.