MEDICARE: CAROLYN CHAPMAN MHPP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	6308	OK
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1245574359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLYN CHAPMAN MHPP

Provider Business Mailing Address
First Line	:	2808 CHAUCER DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-2814
Country	:	US
Telephone Number	:	405-693-1332
Fax Number	:

Provider Business Practice Location Address
First Line	:	2808 CHAUCER DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-2814
Country	:	US
Telephone Number	:	405-693-1332
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2012
Last Update Date	:	10/05/2021

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