Provider Demographics
NPI:1457650913
Name:SCHAFFER, KIMBERLY ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:SCHAFFER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:ANN
Other - Last Name:ARGABRIGHT OR NEWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2050 LARKIN AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-5899
Mailing Address - Country:US
Mailing Address - Phone:847-697-2400
Mailing Address - Fax:847-697-2438
Practice Address - Street 1:2050 LARKIN AVE STE 202
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-5899
Practice Address - Country:US
Practice Address - Phone:847-697-2400
Practice Address - Fax:847-697-2438
Is Sole Proprietor?:No
Enumeration Date:2011-03-23
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490084841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical