Provider Demographics
NPI:1760654776
Name:CHAPMAN, MARK DAVID (LCSW)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:DAVID
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:516 VALLEY BROOK AVENUE
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07071
Mailing Address - Country:US
Mailing Address - Phone:201-935-3322
Mailing Address - Fax:201-460-3698
Practice Address - Street 1:117 KINDERKAMACK RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:RIVER EDGE
Practice Address - State:NJ
Practice Address - Zip Code:07661
Practice Address - Country:US
Practice Address - Phone:201-441-9335
Practice Address - Fax:201-441-9711
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053478001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical