Provider Demographics
NPI:1518166503
Name:CHAPMAN, BEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:BEN
Middle Name:
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9418 KAREN DR
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL
Mailing Address - State:MI
Mailing Address - Zip Code:48818-9704
Mailing Address - Country:US
Mailing Address - Phone:989-235-5828
Mailing Address - Fax:
Practice Address - Street 1:20 MONROE CENTER NE
Practice Address - Street 2:SUITE 201
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503
Practice Address - Country:US
Practice Address - Phone:616-458-6070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301007039103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth