Provider Demographics
NPI:1558317966
Name:FARRAR-SCHNEIDER, DEBRA (PHD, HSPP)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:
Last Name:FARRAR-SCHNEIDER
Suffix:
Gender:F
Credentials:PHD, HSPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1564
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46384-1564
Mailing Address - Country:US
Mailing Address - Phone:219-462-6705
Mailing Address - Fax:219-464-4318
Practice Address - Street 1:2101 COMEFORD RD
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-8385
Practice Address - Country:US
Practice Address - Phone:219-462-6705
Practice Address - Fax:219-464-4318
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20041239A103TB0200X, 103TC0700X, 103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200717130AMedicaid
IN200536380Medicaid
IN200650880Medicaid
IN200173830AMedicaid
IN200447720AMedicaid
IN200173830BMedicaid