Provider Demographics
NPI:1578330874
Name:HOWCROFT-CHAPPLE, CHARNISE (MA, AMFT)
Entity Type:Individual
Prefix:
First Name:CHARNISE
Middle Name:
Last Name:HOWCROFT-CHAPPLE
Suffix:
Gender:F
Credentials:MA, AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 170362
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30317-0362
Mailing Address - Country:US
Mailing Address - Phone:213-709-4619
Mailing Address - Fax:
Practice Address - Street 1:2625 WILSON ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503-4829
Practice Address - Country:US
Practice Address - Phone:213-709-4619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA135289106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist