Provider Demographics
NPI:1366636003
Name:CHAMPNEY, DAVID CAMERON JR (LPC, NCC, MAC, CTTS)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:CAMERON
Last Name:CHAMPNEY
Suffix:JR
Gender:M
Credentials:LPC, NCC, MAC, CTTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2325 CHIPPEWA ST.
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4225 LAPALCO BLVD
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072
Practice Address - Country:US
Practice Address - Phone:504-371-9397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-05
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1391101YA0400X
NC6560101YP2500X
MO2009024347101YP2500X
LA6230101YP2500X
TX73929101YP2500X
KS2754101YP2500X
NM0174701101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103942Medicaid