Provider Demographics
NPI:1093908071
Name:HELEN D. SCHANDOLPH, INC
Entity Type:Organization
Organization Name:HELEN D. SCHANDOLPH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:DUNN
Authorized Official - Last Name:SCHANDOLPH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:912-355-3881
Mailing Address - Street 1:POST OFFICE BOX 13309
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31416
Mailing Address - Country:US
Mailing Address - Phone:912-355-3881
Mailing Address - Fax:912-355-3887
Practice Address - Street 1:224 STEPHENSON AVE
Practice Address - Street 2:SUITE C
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-5920
Practice Address - Country:US
Practice Address - Phone:912-355-3881
Practice Address - Fax:912-355-3887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW30681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP6610Medicare UPIN