Provider Demographics
NPI:1134318322
Name:CHAPMAN CP, PAMELA
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:CHAPMAN CP
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:P.
Other - Middle Name:
Other - Last Name:CHAPMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:5350 E LIVINGSTON AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-6807
Mailing Address - Country:US
Mailing Address - Phone:614-856-4377
Mailing Address - Fax:614-856-4378
Practice Address - Street 1:5350 E LIVINGSTON AVENUE
Practice Address - Street 2:SUITE 104
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-6807
Practice Address - Country:US
Practice Address - Phone:614-856-4377
Practice Address - Fax:614-856-4378
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5121103TB0200X, 103TC0700X, 103TC1900X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1649545567OtherPSYCHOLOGIST EDUCATOR ADVOCATE CONSULTANT ERUDITE TASK FORCE
OH2073894Medicaid
OH1881734549OtherPAMELA CHAPMAN, PH.D., INC.
OH217701OtherMT CARMEL BEHAVIORAL HEAL
OH2073894Medicaid
OH2073894Medicaid
OHCHCP21424Medicare PIN