1881734549 NPI number — PAMELA CHAPMAN PHD INC

Table of content: (NPI 1881734549)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881734549 NPI number — PAMELA CHAPMAN PHD INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PAMELA CHAPMAN PHD INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PAMELA CHAPMAN PHD PSYCHOLOGIST LLC
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881734549
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/30/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5350 E LIVINGSTON AVE
Provider Second Line Business Mailing Address:
SUITE 104
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43232-6807
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-856-4377
Provider Business Mailing Address Fax Number:
614-856-4378

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5350 E LIVINGSTON AVENUE
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43232-6807
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-856-4377
Provider Business Practice Location Address Fax Number:
614-856-4378
Provider Enumeration Date:
02/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CHAPMAN
Authorized Official First Name:
PAMELA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER PSYCHOLOGIST
Authorized Official Telephone Number:
614-856-4377

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  5121 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1649545567 . This is a "PSYCHOLOGIST EDUCATOR ADVOCATE CONSULTANT ERUDITE TASK FORCE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 217701 . This is a "MT CARMEL BEH HEALTHCARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2073894 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1134318322 . This is a "PAMELA CHAPMAN, NPI" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 27564791400 . This is a "BUREAU OF WORKERS COMP" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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