Provider Demographics
NPI:1366236267
Name:CHAPDELAINE, JONATHAN R
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:R
Last Name:CHAPDELAINE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:389 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48040-1140
Mailing Address - Country:US
Mailing Address - Phone:810-364-9885
Mailing Address - Fax:
Practice Address - Street 1:211 N SHIAWASSEE ST STE A
Practice Address - Street 2:
Practice Address - City:CORUNNA
Practice Address - State:MI
Practice Address - Zip Code:48817-1444
Practice Address - Country:US
Practice Address - Phone:989-928-3566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)