NPIMap

Organization Active NPI

Champions Wellness LLC

  • Clinical Psychologist
  • South Hadley, MA
National Provider Identifier
1851706097
Registry record updated Jun 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
9903 Issued in MA
Legal business name
CHAMPIONS WELLNESS LLC
Practice address
7 Hadley St
Suite 4
South Hadley, MA 01075-1147
Phone
(786) 269-7819
Fax
(413) 437-7826
NPI assigned
Jun 26, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2014

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

Authorized official

Name
Dr. Laura DM Grant, PSYDNPI 1174936231
Title
Director-Member
Phone
(786) 269-7819

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 9903 MA Primary

Addresses

Primary practice location

7 Hadley St
Suite 4
South Hadley, MA 01075-1147

Mailing address

7 Hadley St
Suite 4
South Hadley, MA 01075-1147
Phone (786) 269-7819

National Provider Directory

National Provider Directory

Locations

7 Hadley St
Ste 4
South Hadley, MA 01075
Phone (786) 269-7819

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403740800000",
    "number": "1851706097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 HADLEY ST",
            "address_2": "SUITE 4",
            "city": "SOUTH HADLEY",
            "state": "MA",
            "postal_code": "010751147",
            "telephone_number": "786-269-7819",
            "fax_number": "413-437-7826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 HADLEY ST",
            "address_2": "SUITE 4",
            "city": "SOUTH HADLEY",
            "state": "MA",
            "postal_code": "010751147",
            "telephone_number": "786-269-7819",
            "fax_number": "413-437-7826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPIONS WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-26",
        "last_updated": "2014-06-26",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "DM",
        "authorized_official_title_or_position": "DIRECTOR-MEMBER",
        "authorized_official_telephone_number": "786-269-7819",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "9903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Hadley, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.