Provider Demographics
NPI:1568582302
Name:CHAPKO, WILLIAM THOMAS (LPC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:THOMAS
Last Name:CHAPKO
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815B CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28112-5801
Mailing Address - Country:US
Mailing Address - Phone:704-225-8245
Mailing Address - Fax:
Practice Address - Street 1:815B CIRCLE DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-5801
Practice Address - Country:US
Practice Address - Phone:704-225-8245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3051101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102776Medicaid