Provider Demographics
NPI:1033862297
Name:CHAPMAN, JESSICA (LISW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8748 LAKE IN THE WOODS TRL
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-4336
Mailing Address - Country:US
Mailing Address - Phone:847-334-2895
Mailing Address - Fax:
Practice Address - Street 1:147 BELL ST STE 206
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44022-2947
Practice Address - Country:US
Practice Address - Phone:847-334-2895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-28
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.21033111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical