Provider Demographics
NPI:1497756381
Name:CHAPPLE, CYNTHIA (LCSW R)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:CHAPPLE
Suffix:
Gender:F
Credentials:LCSW R
Other - Prefix:
Other - First Name:CYTHIA
Other - Middle Name:SIMPSON
Other - Last Name:ADASEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW R
Mailing Address - Street 1:1 OXFORD XING
Mailing Address - Street 2:STE 6
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-3200
Mailing Address - Country:US
Mailing Address - Phone:315-732-8880
Mailing Address - Fax:315-732-2705
Practice Address - Street 1:1 OXFORD XING
Practice Address - Street 2:STE 6
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-3200
Practice Address - Country:US
Practice Address - Phone:315-732-8880
Practice Address - Fax:315-732-2705
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0309131101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY375510OtherMVP
NY375510OtherMVP