# CHAMPION FAMILY THERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255812566
- **Authorized official:** JESSICA CHAMPION LMFT (OWNER)
- **Authorized official phone:** (541) 632-3909

## Contact information

- **Practice address:** 240 COUNTRY CLUB RD STE B, EUGENE, OR 97401-2479
- **Practice address phone:** (541) 343-7200
- **Practice address fax:** (844) 364-4271
- **Mailing address:** 1574 COBURG RD, EUGENE, OR 97401-4802
- **Mailing address phone:** (541) 343-7200
- **Mailing address fax:** (844) 364-4271

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 08/24/2018
- **Last updated:** 10/23/2024