Provider Demographics
NPI:1033722889
Name:MOGAVERO-CLINE, CHAPARRELLE (MA, EDM)
Entity Type:Individual
Prefix:
First Name:CHAPARRELLE
Middle Name:
Last Name:MOGAVERO-CLINE
Suffix:
Gender:F
Credentials:MA, EDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2731 E CARTHAY CIR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-4751
Mailing Address - Country:US
Mailing Address - Phone:310-621-6646
Mailing Address - Fax:
Practice Address - Street 1:1525 11TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-3903
Practice Address - Country:US
Practice Address - Phone:310-621-6646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-30
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60983680101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health