Provider Demographics
NPI:1891322749
Name:CHAPPLE LOVE, LAUREN (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:CHAPPLE LOVE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:L.
Other - Middle Name:E
Other - Last Name:CHAPPLE-LOVE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:2770 S MARYLAND PKWY STE 105
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-1564
Mailing Address - Country:US
Mailing Address - Phone:702-483-8017
Mailing Address - Fax:
Practice Address - Street 1:2770 S MARYLAND PKWY STE 105
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-1564
Practice Address - Country:US
Practice Address - Phone:702-483-8017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
NVPY0976103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV250012271Medicaid