Provider Demographics
NPI:1902924806
Name:HOESE, FAYE CHAPMAN (LPC)
Entity type:Individual
Prefix:
First Name:FAYE
Middle Name:CHAPMAN
Last Name:HOESE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:FAYE
Other - Last Name:CHAPMAN HOESE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 544
Mailing Address - Street 2:
Mailing Address - City:BISBEE
Mailing Address - State:AZ
Mailing Address - Zip Code:85603-0544
Mailing Address - Country:US
Mailing Address - Phone:520-249-8061
Mailing Address - Fax:520-432-3585
Practice Address - Street 1:24 HOWELL AVE.
Practice Address - Street 2:BOX 544
Practice Address - City:BISBEE
Practice Address - State:AZ
Practice Address - Zip Code:85603
Practice Address - Country:US
Practice Address - Phone:520-249-8061
Practice Address - Fax:520-432-3585
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPX-10747101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ766173OtherAHCCCS