Provider Demographics
NPI:1881356764
Name:CHAPMAN, MARILLA J (LCSW)
Entity type:Individual
Prefix:
First Name:MARILLA
Middle Name:J
Last Name:CHAPMAN
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:SHANE
Other - Middle Name:
Other - Last Name:BOYINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:1631 ELYSIAN FIELDS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70117-8208
Mailing Address - Country:US
Mailing Address - Phone:504-821-2601
Mailing Address - Fax:888-736-9806
Practice Address - Street 1:1631 ELYSIAN FIELDS AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70117-8208
Practice Address - Country:US
Practice Address - Phone:504-821-2601
Practice Address - Fax:888-736-9806
Is Sole Proprietor?:No
Enumeration Date:2021-10-08
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA160441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2621475Medicaid