Provider Demographics
NPI:1376619619
Name:SCHAUGAARD, CHAD T (LCSW)
Entity Type:Individual
Prefix:MR
First Name:CHAD
Middle Name:T
Last Name:SCHAUGAARD
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1169 CALL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-3077
Mailing Address - Country:US
Mailing Address - Phone:208-406-7734
Mailing Address - Fax:
Practice Address - Street 1:1169 CALL CREEK DR
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-3077
Practice Address - Country:US
Practice Address - Phone:208-406-7734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0181331041C0700X
NMX-059161041C0700X
IDLCSW-303271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical