Provider Demographics
NPI:1154844595
Name:SCHAEFER, CAROL M (MS)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:M
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2960 W GERMANTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19403-1060
Mailing Address - Country:US
Mailing Address - Phone:610-630-8540
Mailing Address - Fax:610-630-8557
Practice Address - Street 1:2960 W GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19403-1060
Practice Address - Country:US
Practice Address - Phone:610-630-8540
Practice Address - Fax:610-630-8557
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-006565-L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1639402589OtherUS GOVT