Provider Demographics
NPI:1528503976
Name:CHAPPLE, CLOTEAL
Entity type:Individual
Prefix:
First Name:CLOTEAL
Middle Name:
Last Name:CHAPPLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 PRESTON BLVD APT 205
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-4976
Mailing Address - Country:US
Mailing Address - Phone:318-400-6953
Mailing Address - Fax:
Practice Address - Street 1:1945 E 70TH ST STE E-2
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5347
Practice Address - Country:US
Practice Address - Phone:318-227-4999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-21
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health