1134318322 NPI number — PAMELA CHAPMAN CP

Table of content: PAMELA CHAPMAN CP (NPI 1134318322)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134318322 NPI number — PAMELA CHAPMAN CP

Organization/Personal Information

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

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHAPMAN
Provider Other First Name:
P.
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PH.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1134318322
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/01/2012
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:
10/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TB0200X , with the licence number:  5121 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • 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" .
  • Taxonomy code: 103TC1900X , with the licence number: 5121 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TF0200X , with the licence number: 5121 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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: 2073894 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1881734549 . This is a "PAMELA CHAPMAN, PH.D., INC." identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 217701 . This is a "MT CARMEL BEHAVIORAL HEAL" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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