Provider Demographics
NPI:1164980645
Name:SCHAFER, STEPHANIE M (MED, LPCC, NCC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:M
Last Name:SCHAFER
Suffix:
Gender:F
Credentials:MED, LPCC, NCC
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:M
Other - Last Name:PELLETIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3369 39TH ST S STE 2
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-7542
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3369 39TH ST S STE 2
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-7542
Practice Address - Country:US
Practice Address - Phone:701-532-1353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-04
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND864-2-1-16-334101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional