Provider Demographics
NPI:1245395953
Name:CHAPPLE, ALLISON GORDON (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:GORDON
Last Name:CHAPPLE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 STONEBROOK LN
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27104-5135
Mailing Address - Country:US
Mailing Address - Phone:336-765-2228
Mailing Address - Fax:336-794-1655
Practice Address - Street 1:340 STONEBROOK LN
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27104-5135
Practice Address - Country:US
Practice Address - Phone:336-765-2228
Practice Address - Fax:336-794-1655
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4840101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC4840OtherLPC