Provider Demographics
NPI:1710870522
Name:CHAMPIONS MENTAL HEALTH & WELLNESS
Entity type:Organization
Organization Name:CHAMPIONS MENTAL HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARYANN
Authorized Official - Middle Name:CUNNINGHAM
Authorized Official - Last Name:MATHESON
Authorized Official - Suffix:
Authorized Official - Credentials:GNP-BC, PMHNP-BC
Authorized Official - Phone:713-898-8176
Mailing Address - Street 1:PO BOX 11532
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77391-1532
Mailing Address - Country:US
Mailing Address - Phone:713-898-8176
Mailing Address - Fax:713-597-5897
Practice Address - Street 1:13810 CHAMPION FOREST DR STE 150
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-1883
Practice Address - Country:US
Practice Address - Phone:713-487-5854
Practice Address - Fax:713-597-5897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty