Provider Demographics
NPI:1467142901
Name:SCHAEFFER, RONDA SUE (MS LPC)
Entity Type:Individual
Prefix:
First Name:RONDA
Middle Name:SUE
Last Name:SCHAEFFER
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 MINERAL HEIGHTS ST
Mailing Address - Street 2:
Mailing Address - City:SODA SPRINGS
Mailing Address - State:ID
Mailing Address - Zip Code:83276-1546
Mailing Address - Country:US
Mailing Address - Phone:208-220-3915
Mailing Address - Fax:
Practice Address - Street 1:20 N MAIN ST STE 6
Practice Address - Street 2:
Practice Address - City:MALAD CITY
Practice Address - State:ID
Practice Address - Zip Code:83252-1281
Practice Address - Country:US
Practice Address - Phone:208-766-7623
Practice Address - Fax:833-821-3013
Is Sole Proprietor?:No
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-9374101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional