Provider Demographics
NPI:1225270622
Name:SEEGERS-SCHAFER, SHELBY JO (LCSW)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:JO
Last Name:SEEGERS-SCHAFER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62901-2538
Mailing Address - Country:US
Mailing Address - Phone:618-351-1279
Mailing Address - Fax:618-351-6369
Practice Address - Street 1:804 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62901-2538
Practice Address - Country:US
Practice Address - Phone:618-351-1279
Practice Address - Fax:618-351-6369
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-31
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490132741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical