Healthcare Provider Details

I. General information

NPI: 1841019908
Provider Name (Legal Business Name): CHAPLA ASSESSMENT & THERAPY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2024
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2741 INDIAN SCHOOL RD NE STE 104
ALBUQUERQUE NM
87106-2653
US

IV. Provider business mailing address

2741 INDIAN SCHOOL RD NE STE 104
ALBUQUERQUE NM
87106-2653
US

V. Phone/Fax

Practice location:
  • Phone: 505-532-3008
  • Fax:
Mailing address:
  • Phone: 505-532-3008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. BROOKE ALISSA CHAPLA
Title or Position: CEO AND OWNER
Credential: PHD
Phone: 505-532-3008