Provider Demographics
NPI:1780726091
Name:CHAPPELL, PATRICIA D (LCSW)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:D
Last Name:CHAPPELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 ROCK CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23927-4247
Mailing Address - Country:US
Mailing Address - Phone:434-755-5068
Mailing Address - Fax:434-755-5068
Practice Address - Street 1:1617A ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-5797
Practice Address - Country:US
Practice Address - Phone:434-239-4949
Practice Address - Fax:434-239-4955
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040012881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4945131OtherVIRGINIA PREMIER
VA7011857OtherMAMSI
VAO85730OtherOPTIMA
VA110322OtherANTHEM
VA2169209OtherMAMSI
VA263127-000OtherMAGELLAN
VA111034OtherANTHEM
VA110322OtherANTHEM