Provider Demographics
NPI:1982400339
Name:CHAPMAN, DIANNA RIDGELY (LCMHCA)
Entity type:Individual
Prefix:
First Name:DIANNA
Middle Name:RIDGELY
Last Name:CHAPMAN
Suffix:
Gender:
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19224 WILDCAT TRL
Mailing Address - Street 2:
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036-7856
Mailing Address - Country:US
Mailing Address - Phone:704-654-6274
Mailing Address - Fax:
Practice Address - Street 1:107 N MAIN ST
Practice Address - Street 2:
Practice Address - City:DAVIDSON
Practice Address - State:NC
Practice Address - Zip Code:28036-9402
Practice Address - Country:US
Practice Address - Phone:704-218-9313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA20594101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health