Provider Demographics
NPI:1407418437
Name:CHIPMAN, PAUL RAYMOND II (LPC)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:RAYMOND
Last Name:CHIPMAN
Suffix:II
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4615 LAKEFIELD MEWS PL APT F
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23231-4188
Mailing Address - Country:US
Mailing Address - Phone:804-387-9127
Mailing Address - Fax:
Practice Address - Street 1:13354 MIDLOTHIAN TPKE
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-4258
Practice Address - Country:US
Practice Address - Phone:804-277-9355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-29
Last Update Date:2019-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008405101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty