Provider Demographics
NPI:1437351962
Name:SCHLABACH, PRISCILLA ANN (LISW)
Entity Type:Individual
Prefix:MRS
First Name:PRISCILLA
Middle Name:ANN
Last Name:SCHLABACH
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:MS
Other - First Name:PRISCILLA
Other - Middle Name:ANN
Other - Last Name:KELLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 1349
Mailing Address - Street 2:BORDER AREA MENTAL HEALTH SERVICE
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88062-1349
Mailing Address - Country:US
Mailing Address - Phone:575-388-4497
Mailing Address - Fax:575-534-1150
Practice Address - Street 1:315 S HUDSON ST
Practice Address - Street 2:BORDER AREA MENTAL HEALTH SERVICES, INC.
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061-6184
Practice Address - Country:US
Practice Address - Phone:575-388-4412
Practice Address - Fax:575-534-1150
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK31281041C0700X
NM1-077041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK3128OtherSTATE OF OKLAHOMA
NMI-07704OtherSTATE OF NEW MEXICO