Provider Demographics
NPI:1811517865
Name:CHAPMAN, HEATHER (LPC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:ETHERINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2255 CUMBERLAND PKWY SE BLDG 900
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-4529
Mailing Address - Country:US
Mailing Address - Phone:678-400-9300
Mailing Address - Fax:
Practice Address - Street 1:2255 CUMBERLAND PKWY
Practice Address - Street 2:BLDG 900 STE 250
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339
Practice Address - Country:US
Practice Address - Phone:678-400-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-20
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006237101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1174097463OtherNPI TYPE 2