Healthcare Provider Details

I. General information

NPI: 1114625241
Provider Name (Legal Business Name): SCOTT CHAPMAN LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2023
Last Update Date: 02/17/2023
Certification Date: 02/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 ASPEN DR STE 101A
SANTA FE NM
87505-5579
US

IV. Provider business mailing address

86 OLD GALISTEO WAY
SANTA FE NM
87508-9477
US

V. Phone/Fax

Practice location:
  • Phone: 505-424-3119
  • Fax:
Mailing address:
  • Phone: 505-639-9717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCTB-2003-0026
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: