Provider Demographics
NPI:1336696830
Name:CHAPEL, NICOLE BLANCHARD (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:BLANCHARD
Last Name:CHAPEL
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:MISS
Other - First Name:NICOLE
Other - Middle Name:DENAE
Other - Last Name:BLANCHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:420 LAMARQUE ST
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-5935
Mailing Address - Country:US
Mailing Address - Phone:985-774-6131
Mailing Address - Fax:
Practice Address - Street 1:5001 HWY 190, EAST SERVICE RD
Practice Address - Street 2:SUITE C6
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70443
Practice Address - Country:US
Practice Address - Phone:985-774-6131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3617101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor