Provider Demographics
NPI:1790797850
Name:LACHAPELLE, MARK EDMUND (MSW)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:EDMUND
Last Name:LACHAPELLE
Suffix:
Gender:M
Credentials:MSW
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Mailing Address - Street 1:1660 HIGHWAY 100 S
Mailing Address - Street 2:SUITE 334
Mailing Address - City:SAINT LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1529
Mailing Address - Country:US
Mailing Address - Phone:952-928-8474
Mailing Address - Fax:952-928-8532
Practice Address - Street 1:1660 HIGHWAY 100 S
Practice Address - Street 2:SUITE 334
Practice Address - City:SAINT LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-1529
Practice Address - Country:US
Practice Address - Phone:952-928-8474
Practice Address - Fax:952-928-8532
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN9671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical