Provider Demographics
NPI:1033620935
Name:CHAPUT, MARNE LEA (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:MARNE
Middle Name:LEA
Last Name:CHAPUT
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 E 24TH ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-3862
Mailing Address - Country:US
Mailing Address - Phone:612-373-3366
Mailing Address - Fax:612-333-4111
Practice Address - Street 1:1725 2ND AVE SO
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403
Practice Address - Country:US
Practice Address - Phone:612-373-3366
Practice Address - Fax:612-333-4111
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-18
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN22915104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker