Healthcare Provider Details

I. General information

NPI: 1164106019
Provider Name (Legal Business Name): STEPHANIE RENEE CHAPMAN PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2023
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 GOTHIC ST
NORTHAMPTON MA
01060-3059
US

IV. Provider business mailing address

15 GOTHIC ST
NORTHAMPTON MA
01060-3059
US

V. Phone/Fax

Practice location:
  • Phone: 774-402-4758
  • Fax:
Mailing address:
  • Phone: 774-402-4758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberNA
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: