Provider Demographics
NPI:1194118448
Name:CHAMPER, DANIEL (LCPC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:CHAMPER
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 139
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59624-0139
Mailing Address - Country:US
Mailing Address - Phone:406-442-7920
Mailing Address - Fax:406-442-7949
Practice Address - Street 1:3240 DREDGE DR
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59602-0548
Practice Address - Country:US
Practice Address - Phone:406-422-7920
Practice Address - Fax:406-442-7949
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSWP-LCPC-LIC-11536101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTSWP-LCPC-LIC-11536OtherSTATE LICENSE