Individual ProviderJan ChampionCounselorBehavioral Health & Social Service ProvidersPractice Address217 Knowles St, Suite 140, Royal Oak, MI 48067-2767(248) 542-3446PECOS EnrollmentBased on the most recent information from CMS, provider Jan Champion does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1750416368Provider TypeIndividualFull NameChampion, JanCredentialLMSW, ACSWGenderFemaleSole ProprietorYesEnumeration Date2/22/2007Last Updated5/20/2015Contact InformationPractice LocationPractice Address217 Knowles St, Suite 140, Royal Oak, MI 48067-2767Phone(248) 542-3446Fax(248) 677-3978Mailing LocationMailing Address217 Knowles St, Royal Oak, MI 48067-2767Phone(248) 542-3446Fax(248) 589-1765Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense680104643Michigan