Healthcare Provider Details

I. General information

NPI: 1396016556
Provider Name (Legal Business Name): ANDRE PETER CHAPLIN PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2012
Last Update Date: 09/17/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GRAFENWOEHR ARMY HEALTH CLINIC BUILDING 501
GRAFENWOEHR NY
09114
US

IV. Provider business mailing address

CMR 415 BOX 7185
APO AE
09114-1072
US

V. Phone/Fax

Practice location:
  • Phone: 703-665-4114
  • Fax:
Mailing address:
  • Phone: 703-665-4114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1730
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1730
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: