| Doctor Name: | MS. ELAINE POTTER CHAMPION |
| NPI Number: | 1144642984 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC, CSAC, CRC |
| License Number: | 0710101850 |
| Business Practice Address: | 1241 Mall Dr North Chesterfield, VA - 232354879 |
| Business Phone Number: | 8043107620 |
| Business Fax Number: | 8044217127 |
| Mailing Address: | 1802 Cedar Hollow Ct, HENRICO |
| State: | VA |
| Postal Code: | 232383441 |
| Phone Number: | 8043107620 |
| Fax Number: | 8044217127 |
| NPI Enumeration Date: | 01/14/2014 |
| NPI Last Update Date: | 01/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 0710101850 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |