Provider Demographics
NPI:1659415909
Name:SCHAAFSMA, MELANIE CATLIN (MSW, LSW, PHD)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:CATLIN
Last Name:SCHAAFSMA
Suffix:
Gender:F
Credentials:MSW, LSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2604 S FORK DR
Mailing Address - Street 2:
Mailing Address - City:VANDALIA
Mailing Address - State:IL
Mailing Address - Zip Code:62471-3815
Mailing Address - Country:US
Mailing Address - Phone:618-283-1202
Mailing Address - Fax:618-283-1376
Practice Address - Street 1:1404 N 5TH ST
Practice Address - Street 2:
Practice Address - City:VANDALIA
Practice Address - State:IL
Practice Address - Zip Code:62471-1039
Practice Address - Country:US
Practice Address - Phone:618-283-2883
Practice Address - Fax:618-283-2883
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical