Healthcare Provider Details

I. General information

NPI: 1194445916
Provider Name (Legal Business Name): EVE CHIPMAN BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2022
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1065 MEDINA RD STE 300
MEDINA OH
44256-5374
US

IV. Provider business mailing address

445 E DUBLIN GRANVILLE RD
WORTHINGTON OH
43085-3192
US

V. Phone/Fax

Practice location:
  • Phone: 614-844-3800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2833830
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: