Provider Demographics
NPI:1558426114
Name:SCHAEFER, SUSAN MARIE (LMHC, LAC)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:MARIE
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:LMHC, LAC
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:MARIE
Other - Last Name:LOVAAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC, LAC
Mailing Address - Street 1:2004 PORTAGE AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46616-2033
Mailing Address - Country:US
Mailing Address - Phone:574-210-6251
Mailing Address - Fax:
Practice Address - Street 1:660 MORTHLAND DR STE A
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46385-4638
Practice Address - Country:US
Practice Address - Phone:219-460-9200
Practice Address - Fax:219-465-1245
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN86000139A101YA0400X
IN39001820A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)