Provider Demographics
NPI:1346213584
Name:CHAPMAN, JOHN MICHAEL (CADC III/LPC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:MICHAEL
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:CADC III/LPC
Other - Prefix:
Other - First Name:MIKE
Other - Middle Name:
Other - Last Name:CHAPMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CADC III/LPC
Mailing Address - Street 1:1776 SW MADISON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-1715
Mailing Address - Country:US
Mailing Address - Phone:971-386-2278
Mailing Address - Fax:503-224-4494
Practice Address - Street 1:703 NE HANCOCK ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-3955
Practice Address - Country:US
Practice Address - Phone:503-230-9875
Practice Address - Fax:503-331-3441
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR04-11-66101YA0400X
ORC1554101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500724276Medicaid
WA2025953Medicaid
OR500640316Medicaid