Provider Demographics
NPI:1245956788
Name:CHAPMAN-DELOGE, LYNN R (MA, LMHC, BC-DMT)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:R
Last Name:CHAPMAN-DELOGE
Suffix:
Gender:F
Credentials:MA, LMHC, BC-DMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 CHAPMAN ST UNIT 203
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-2040
Mailing Address - Country:US
Mailing Address - Phone:781-828-2418
Mailing Address - Fax:
Practice Address - Street 1:500 CHAPMAN ST UNIT 203
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2040
Practice Address - Country:US
Practice Address - Phone:781-828-2418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11549101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health