Provider Demographics
NPI:1104663848
Name:RODRIGUEZ-CHAPMAN, JULIA SUZANNE (LCMHCA)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:SUZANNE
Last Name:RODRIGUEZ-CHAPMAN
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1788
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:NC
Mailing Address - Zip Code:28730-1788
Mailing Address - Country:US
Mailing Address - Phone:904-415-1691
Mailing Address - Fax:
Practice Address - Street 1:486 SPAULDING RD STE B
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752-5212
Practice Address - Country:US
Practice Address - Phone:828-652-2919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
NCA19920101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional