Provider Demographics
NPI:1437719960
Name:CHAPMAN, ANTOINETTE MONIQUE (LPC, CAADC)
Entity Type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:MONIQUE
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:LPC, CAADC
Other - Prefix:
Other - First Name:ANTOINETTE
Other - Middle Name:MONIQUE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, CAADC
Mailing Address - Street 1:601 MARTIN LUTHER KING JR ST
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49507-1304
Mailing Address - Country:US
Mailing Address - Phone:616-570-0573
Mailing Address - Fax:616-965-3460
Practice Address - Street 1:601 MARTIN LUTHER KING JR ST
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49507-1304
Practice Address - Country:US
Practice Address - Phone:616-570-0573
Practice Address - Fax:616-965-3460
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-17
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401222860101YA0400X
MI6451017298101YP2500X
MI6401017298101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6401222860Medicaid
MI6451017298Medicaid
MIC-04959OtherMCBAP