Provider Demographics
NPI:1518636174
Name:SCHAUM, KELCEY M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KELCEY
Middle Name:M
Last Name:SCHAUM
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 RICHARD HARRISON WAY
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26501-1136
Mailing Address - Country:US
Mailing Address - Phone:724-822-2592
Mailing Address - Fax:
Practice Address - Street 1:1640 SKYVIEW LN
Practice Address - Street 2:
Practice Address - City:BRUCETON MILLS
Practice Address - State:WV
Practice Address - Zip Code:26525-6891
Practice Address - Country:US
Practice Address - Phone:304-379-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810007431103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE