Provider Demographics
NPI:1609930197
Name:CHAPPELEAR, WENDY A (LPC)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:A
Last Name:CHAPPELEAR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:A
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:7373 147TH ST W
Mailing Address - Street 2:SUITE #180
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-7690
Mailing Address - Country:US
Mailing Address - Phone:952-432-3220
Mailing Address - Fax:
Practice Address - Street 1:7373 147TH ST W
Practice Address - Street 2:SUITE #180
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-7690
Practice Address - Country:US
Practice Address - Phone:952-432-3220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00021101YP2500X
WI3106-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN11492695OtherCAQH
MN62-58-418OtherUBH
MN41-118292-40-003OtherAMERICAS PPO
MN514K4DA515K4CHOtherBLUE CROSS