Provider Demographics
NPI:1376183210
Name:SCHOFIELD, CASEY ANNE (PHD)
Entity Type:Individual
Prefix:PROF
First Name:CASEY
Middle Name:ANNE
Last Name:SCHOFIELD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-1698
Mailing Address - Country:US
Mailing Address - Phone:518-580-5317
Mailing Address - Fax:
Practice Address - Street 1:125 HIGH ROCK AVE
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-2307
Practice Address - Country:US
Practice Address - Phone:315-430-2917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023572-01103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical