Provider Demographics
NPI:1043443567
Name:CHAPMAN, STACIE-ANN (LCPC)
Entity type:Individual
Prefix:
First Name:STACIE-ANN
Middle Name:
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8510 16TH ST APT 105
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2955
Mailing Address - Country:US
Mailing Address - Phone:301-587-1457
Mailing Address - Fax:
Practice Address - Street 1:8720 GEORGIA AVE STE 308
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3614
Practice Address - Country:US
Practice Address - Phone:301-547-5460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2010-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health