Provider Demographics
NPI:1578618633
Name:LACHAPELLE, NANCY (PHD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:LACHAPELLE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2976 EAST STATE STREET
Mailing Address - Street 2:SUITE 120/106
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616
Mailing Address - Country:US
Mailing Address - Phone:310-375-4633
Mailing Address - Fax:
Practice Address - Street 1:24520 HAWTHORNE BLVD STE 208
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6843
Practice Address - Country:US
Practice Address - Phone:310-375-4633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15307103T00000X, 103TC0700X
IDPSY203467103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist