Basic Information
| Provider Information | |||||||||
| NPI: | 1679855274 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHAPMAN | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | L.M.S.W. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4730 KENSINGTON DR | ||||||||
| Address2: | |||||||||
| City: | WARREN | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480924337 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5863060169 | ||||||||
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| Practice Location | |||||||||
| Address1: | 888 W BIG BEAVER RD | ||||||||
| Address2: | STE 780 | ||||||||
| City: | TROY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480844745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7342858282 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/09/2011 | ||||||||
| LastUpdateDate: | 05/08/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 6801074286 | MI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041S0200X | 6801074286 | MI | N | Behavioral Health & Social Service Providers | Social Worker | School |
No ID Information.