Provider Demographics
NPI:1447404033
Name:CHAPPELL, EMILY F (LCSW, ACSW, ASW-G, C)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:F
Last Name:CHAPPELL
Suffix:
Gender:F
Credentials:LCSW, ACSW, ASW-G, C
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:F
Other - Last Name:LEIRER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, CASAC
Mailing Address - Street 1:3239 ROUTE 112
Mailing Address - Street 2:SUITE 5
Mailing Address - City:MEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11763
Mailing Address - Country:US
Mailing Address - Phone:631-672-9651
Mailing Address - Fax:631-320-1779
Practice Address - Street 1:3239 ROUTE 112
Practice Address - Street 2:SUITE 5
Practice Address - City:MEDFORD
Practice Address - State:NY
Practice Address - Zip Code:11763
Practice Address - Country:US
Practice Address - Phone:631-672-9651
Practice Address - Fax:631-320-1779
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-09
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10248101YA0400X
NY0640971041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical