Provider Demographics
NPI:1275862427
Name:CHAPPELL, DIAHANN L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DIAHANN
Middle Name:L
Last Name:CHAPPELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 127
Mailing Address - Street 2:
Mailing Address - City:SEASIDE
Mailing Address - State:CA
Mailing Address - Zip Code:93955-0127
Mailing Address - Country:US
Mailing Address - Phone:831-392-1500
Mailing Address - Fax:831-392-1501
Practice Address - Street 1:1069 BROADWAY AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:SEASIDE
Practice Address - State:CA
Practice Address - Zip Code:93955-4996
Practice Address - Country:US
Practice Address - Phone:831-392-1500
Practice Address - Fax:831-392-1501
Is Sole Proprietor?:No
Enumeration Date:2009-12-17
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA176671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical