Provider Demographics
NPI:1598111858
Name:CHAPIN, AMANDA SUE (LMHC)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:SUE
Last Name:CHAPIN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-3338
Mailing Address - Country:US
Mailing Address - Phone:617-272-0547
Mailing Address - Fax:
Practice Address - Street 1:170 CENTRE ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-3338
Practice Address - Country:US
Practice Address - Phone:617-272-0547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9172101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health