Provider Demographics
NPI:1063961563
Name:CHAPPUIS, KELLY LAUREN (LPC)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:LAUREN
Last Name:CHAPPUIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7015 PLUM CREEK TRAIL LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77087-2565
Mailing Address - Country:US
Mailing Address - Phone:832-928-4953
Mailing Address - Fax:
Practice Address - Street 1:707 S FRY RD STE 465
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2259
Practice Address - Country:US
Practice Address - Phone:281-940-8515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-25
Last Update Date:2016-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72745101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional