Provider Demographics
NPI:1750602751
Name:CHAPMAN, MARK E (LMSW)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:E
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5812 VINTON AVE NW
Mailing Address - Street 2:
Mailing Address - City:COMSTOCK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:49321-8314
Mailing Address - Country:US
Mailing Address - Phone:616-784-3834
Mailing Address - Fax:
Practice Address - Street 1:6728 VINING RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MI
Practice Address - Zip Code:48838-9784
Practice Address - Country:US
Practice Address - Phone:616-225-8220
Practice Address - Fax:616-225-8226
Is Sole Proprietor?:No
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010208411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical