Provider Demographics
NPI:1093225849
Name:LEWIS CHAPMAN, MICHELLE (LPC MED)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:LEWIS CHAPMAN
Suffix:
Gender:F
Credentials:LPC MED
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:CHAPMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC MED
Mailing Address - Street 1:1060 HOGAN LN UNIT 10401
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-4517
Mailing Address - Country:US
Mailing Address - Phone:501-420-2783
Mailing Address - Fax:501-500-6362
Practice Address - Street 1:1060 HOGAN LN UNIT 10401
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-4517
Practice Address - Country:US
Practice Address - Phone:501-420-2783
Practice Address - Fax:501-500-6362
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-06
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP2010085101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor