Provider Demographics
NPI:1437684990
Name:CHAPPELLE, MICAELA (MSW)
Entity Type:Individual
Prefix:
First Name:MICAELA
Middle Name:
Last Name:CHAPPELLE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4507 170TH AVE
Mailing Address - Street 2:
Mailing Address - City:HERSEY
Mailing Address - State:MI
Mailing Address - Zip Code:49639-8785
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4507 170TH AVE
Practice Address - Street 2:
Practice Address - City:HERSEY
Practice Address - State:MI
Practice Address - Zip Code:49639-8785
Practice Address - Country:US
Practice Address - Phone:231-832-7283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-21
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical