MS. CHERYL CHAMPION (LICSW) – Clinical Social Worker, NPI 1265575542

MS. CHERYL CHAMPION (LICSW) is a healthcare provider. based in Coon rapids, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 11195 (MN). The NPI Number for MS. CHERYL CHAMPION (LICSW) is 1265575542

Main info

Female
Sole Proprietor
32 Years Of Experience
Accepts Medicare Assignment
Name
MS. CHERYL CHAMPION (LICSW)
NPI
1265575542
Phone
(763) 427-7964
Address
1930 COON RAPIDS BLVD NW
Enumeration Date
15 February 2007
Last Update Date
7 April 2009

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2184817660
Graduation Year
1994 (32 years ago)
PAC ID
8224192356
Group Practice PAC ID
4486911187
Professional Enrollment ID
I20090204000103
Address ID
MN557922457VI225XXNXXX402
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,310 CLINICAL SOCIAL WORKER in MN

Provider Addresses for MS. CHERYL CHAMPION (LICSW)

  • 1930 COON RAPIDS BLVD NW

    COON RAPIDS, MN 554334708

    Phone: (763) 427-7964

    Fax: (763) 427-7976

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-02-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20090204000103IClinical Social WorkerMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour15618$0
View full utilization report →

Insurance plans in this area (ZIP 55433)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4486911187View full group profile
NameSpecialtyState
Clinical PsychologistMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Clinical Social WorkerMN
-MN
-MN

Reviews

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Frequently asked questions

What identifier follows MS. CHERYL CHAMPION (LICSW) across health systems?
The NPI 1265575542 uniquely identifies MS. CHERYL CHAMPION (LICSW) in U.S. healthcare data.
Is MS. CHERYL CHAMPION (LICSW) currently accepting referrals based on NPI status?
Registry metadata lists MS. CHERYL CHAMPION (LICSW) as active.
How should patients interpret MS. CHERYL CHAMPION (LICSW)'s specialty?
The extract shows Clinical Social Worker for MS. CHERYL CHAMPION (LICSW). Clinical services aligned with this taxonomy classification.
What city is tied to MS. CHERYL CHAMPION (LICSW)?
The directory associates MS. CHERYL CHAMPION (LICSW) with Coon Rapids, Minnesota. Check all listed addresses for suites or satellite offices.
Can I export MS. CHERYL CHAMPION (LICSW)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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