Provider Demographics
NPI:1033610522
Name:SCHAFER, BRANDY KING (MS, LMHC, REAT, NCC)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:KING
Last Name:SCHAFER
Suffix:
Gender:F
Credentials:MS, LMHC, REAT, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 AUTUMN OAKS PL
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-4848
Mailing Address - Country:US
Mailing Address - Phone:407-502-0189
Mailing Address - Fax:
Practice Address - Street 1:122 N 4TH ST STE 2022
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2944
Practice Address - Country:US
Practice Address - Phone:407-502-0189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-21
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH16011101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health