Provider Demographics
NPI:1508962424
Name:CHASSMAN, LINDA (LMFT)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:CHASSMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:DR
Other - First Name:LINDA
Other - Middle Name:CHASSMAN
Other - Last Name:CRADDOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:7275 KIPLING ST
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005-3857
Mailing Address - Country:US
Mailing Address - Phone:720-266-4444
Mailing Address - Fax:202-664-4447
Practice Address - Street 1:7275 KIPLING ST
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005-3857
Practice Address - Country:US
Practice Address - Phone:720-266-4444
Practice Address - Fax:202-664-4447
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC22808106H00000X
CO835106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO35737565Medicaid