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General NPI Number Information
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NPI Number | 1598122285
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Entity Type | Organization
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Legal Business Name | TERRY L. CHAPMAN, LLC
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Dates
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Enumeration Date | 01/26/2016
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Last Update Date | 01/26/2016
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Provider Practice Location Address
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Address Line | 118 ADAMS ST SUITE 203
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City | FAIRMONT
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State | WV
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Zip | 26554-2841
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Country | US
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Telephone | 681-404-6094
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Fax | 681-404-6494
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Provider Business Mailing Address
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Address Line | 118 ADAMS ST SUITE 203
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City | FAIRMONT
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State | WV
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Zip | 26554-2841
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Country | US
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Telephone | 681-404-6094
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Fax | 681-404-6494
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Authorized Official
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Title or Position | SINGLE PROVIDER LLC
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Name | TERRY LYNN CHAPMAN
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Credential | LICSW
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Telephone | 681-404-6094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | DP00943687
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License Number State | WV
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