Provider Demographics
NPI:1952479149
Name:CHAPMAN, ERNESTINE VERONICA (LPC, LCAS, CCS,)
Entity Type:Individual
Prefix:MS
First Name:ERNESTINE
Middle Name:VERONICA
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:LPC, LCAS, CCS,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9370 FALLS OF NEUSE RD STE 203
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-2487
Mailing Address - Country:US
Mailing Address - Phone:919-906-7942
Mailing Address - Fax:
Practice Address - Street 1:9370 FALLS OF NEUSE RD STE 203
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-2487
Practice Address - Country:US
Practice Address - Phone:919-906-7942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2632101Y00000X
101YA0400X
NC34101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102600Medicaid