Provider Demographics
NPI:1881734549
Name:PAMELA CHAPMAN PHD INC
Entity type:Organization
Organization Name:PAMELA CHAPMAN PHD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PSYCHOLOGIST
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 104
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 AVENUE
Practice Address - Street 2:SUITE 104
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:2007-02-08
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5121103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1649545567OtherPSYCHOLOGIST EDUCATOR ADVOCATE CONSULTANT ERUDITE TASK FORCE
OH217701OtherMT CARMEL BEH HEALTHCARE
OH2073894Medicaid
OH1134318322OtherPAMELA CHAPMAN, NPI
OH27564791400OtherBUREAU OF WORKERS COMP
OHCHCP21421Medicare ID - Type UnspecifiedINDIV #
OH1649545567OtherPSYCHOLOGIST EDUCATOR ADVOCATE CONSULTANT ERUDITE TASK FORCE