Provider Demographics
NPI:1649545567
Name:PSYCHOLOGIST EDUCATOR ADVOCATE CONSULTANT ERUDITE TASK FORCE
Entity type:Organization
Organization Name:PSYCHOLOGIST EDUCATOR ADVOCATE CONSULTANT ERUDITE TASK FORCE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:614-856-4377
Mailing Address - Street 1:5350 E LIVINGSTON AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-6807
Mailing Address - Country:US
Mailing Address - Phone:614-856-4377
Mailing Address - Fax:614-856-4378
Practice Address - Street 1:5350 E LIVINGSTON AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-6807
Practice Address - Country:US
Practice Address - Phone:614-856-4377
Practice Address - Fax:614-856-4378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-09
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH27564791400OtherBUREAU OF WORKERS COMPENSATION
OH1134318322OtherPAMELA CHAPMAN, NPI
OH1881734549OtherPAMELA CHAPMAN, PH.D., INC.
OH217701OtherMT. CARMEL BEHAVIORAL HEALTHCARE
OH2073894Medicaid
OHCHCP21421Medicare UPIN
OH2073894Medicaid