Provider Demographics
NPI:1376934083
Name:SCHUMACHER, CHELSEA LYNN (LBA)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:LYNN
Last Name:SCHUMACHER
Suffix:
Gender:F
Credentials:LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 LOUISA AVE
Mailing Address - Street 2:
Mailing Address - City:DUPO
Mailing Address - State:IL
Mailing Address - Zip Code:62239-1307
Mailing Address - Country:US
Mailing Address - Phone:618-910-8000
Mailing Address - Fax:
Practice Address - Street 1:2560 METRO BLVD
Practice Address - Street 2:
Practice Address - City:MARYLAND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63043-2417
Practice Address - Country:US
Practice Address - Phone:314-715-3855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014011772103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst