Provider Demographics
NPI:1336397959
Name:CHAPMAN, CHARLES (LPC)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 JOHN ADAMS ST
Mailing Address - Street 2:STE. 120
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-1695
Mailing Address - Country:US
Mailing Address - Phone:503-804-4133
Mailing Address - Fax:
Practice Address - Street 1:1300 JOHN ADAMS ST
Practice Address - Street 2:STE. 120
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-1695
Practice Address - Country:US
Practice Address - Phone:503-804-4133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3466101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional