Provider Demographics
NPI:1508196932
Name:CHAPPELL HUDGINS, CHASEE SUZANNE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHASEE
Middle Name:SUZANNE
Last Name:CHAPPELL HUDGINS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:CHASEE
Other - Middle Name:
Other - Last Name:CHAPPELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:7810 MOWINKLE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78736-7945
Mailing Address - Country:US
Mailing Address - Phone:512-689-5042
Mailing Address - Fax:
Practice Address - Street 1:205 WILD BASIN RD
Practice Address - Street 2:SUITE 2B
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-3341
Practice Address - Country:US
Practice Address - Phone:512-689-5042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-07
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33978103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling