MEDICARE: PATRICIA D. CHAPPELL LCSW

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	1041C0700X	Clinical Social Worker	0904001288	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4945131	OTHER	VA	VIRGINIA PREMIER
2	7011857	OTHER	VA	MAMSI
3	O85730	OTHER	VA	OPTIMA
4	110322	OTHER	VA	ANTHEM
5	2169209	OTHER	VA	MAMSI
6	263127-000	OTHER	VA	MAGELLAN
7	111034	OTHER	VA	ANTHEM

General Provider Information

NPI Number	:	1780726091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA D. CHAPPELL LCSW

Provider Business Mailing Address
First Line	:	403 ROCK CHURCH RD
Second Line	:
City	:	CLARKSVILLE
State	:	VA
Zip	:	23927-4247
Country	:	US
Telephone Number	:	434-755-5068
Fax Number	:	434-755-5068

Provider Business Practice Location Address
First Line	:	1617A ENTERPRISE DR
Second Line	:
City	:	LYNCHBURG
State	:	VA
Zip	:	24502-5797
Country	:	US
Telephone Number	:	434-239-4949
Fax Number	:	434-239-4955

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

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	02/06/2014

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