Individual
MS. ELAINE POTTER CHAMPION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, CSAC, CRC
Contact information
Practice address
1241 MALL DR, NORTH CHESTERFIELD, VA 23235-4879
(804) 310-7620
(804) 421-7127
Mailing address
1802 CEDAR HOLLOW CT, HENRICO, VA 23238-3441
(804) 310-7620
(804) 421-7127
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710101850
VA
101YP2500X
Professional Counselor
Primary
0701005122
VA
Other
Enumeration date
01/14/2014
Last updated
01/14/2014
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