=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891047403
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MICHEAL D. CHAPMAN PHD & ASSOCIATES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/05/2012
-----------------------------------------------------
Last Update Date | 10/05/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1675 LAWRENCE AVE
-----------------------------------------------------
City | ASHLAND
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41102-5501
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-923-9896
-----------------------------------------------------
Fax | 606-326-0701
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1675 LAWRENCE AVE
-----------------------------------------------------
City | ASHLAND
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41102-5501
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-923-9896
-----------------------------------------------------
Fax | 606-326-0701
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MICHEAL CHAPMAN
-----------------------------------------------------
Credential | PHD, LPCC, NCC
-----------------------------------------------------
Telephone | 606-923-9896
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 0415
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------