Provider Demographics
NPI:1235689506
Name:SCHAAB, CONSANDER YVETTA (ASW)
Entity Type:Individual
Prefix:
First Name:CONSANDER
Middle Name:YVETTA
Last Name:SCHAAB
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:843-789-1620
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:2097 HENRY TECKLENBURG DR STE 211W
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5739
Practice Address - Country:US
Practice Address - Phone:843-958-2555
Practice Address - Fax:843-402-1961
Is Sole Proprietor?:No
Enumeration Date:2016-10-10
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW73522101YM0800X
SCSW15349104100000X
SC153491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker