Provider Demographics
NPI:1023810363
Name:CHAMPION, LEILA (CDCA)
Entity type:Individual
Prefix:
First Name:LEILA
Middle Name:
Last Name:CHAMPION
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4764 FISHBURG RD STE E
Mailing Address - Street 2:
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424-5456
Mailing Address - Country:US
Mailing Address - Phone:317-531-7990
Mailing Address - Fax:
Practice Address - Street 1:4764 FISHBURG RD STE E
Practice Address - Street 2:
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-5456
Practice Address - Country:US
Practice Address - Phone:317-531-7990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)