Theodore Champagne, MA – Mental Health Counselor

Key facts

NPI: 1871183533
Entity type: Individual (NPI type 1)
Primary specialty: Mental Health Counselor 101YM0800X
License: 19626 (FL)
Practice address: 308 Solaris Wharf St
Winter Springs, FL 32708-7107
Phone: (407) 739-1728
NPI assigned: Jan 26, 2021
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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.

Life Journey Counseling and Consulting, LLC Mental Health Counselor · Orlando, FL · NPI 1679091904

NPD (past) MENTAL HEALTH

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Master of Arts

State licenses

License	State	Type	Specialty
19626	FL	MD	Health & Wellness Coach

Practice roles

Organization	Specialty	Status	New patients
Life Journey Counseling and Consulting, LLC	Mental Health	Past since May 7, 2024	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Mental Health Counselor	101YM0800X	19626	FL	Yes

Addresses

Primary practice location

308 Solaris Wharf St
Winter Springs, FL 32708-7107

Mailing address

308 Solaris Wharf St
Winter Springs, FL 32708-7107
Phone (407) 739-1728

Other names

Alexandra Champagne Former name

Other providers in Winter Springs, FL

All providers in Winter Springs, FL · Mental Health Counselor in Florida

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 30, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.