Provider Demographics
NPI:1679190219
Name:SCHAEFER, LAUREN (PHD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 S COLLEGE RD # 1116
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-1632
Mailing Address - Country:US
Mailing Address - Phone:910-442-8188
Mailing Address - Fax:
Practice Address - Street 1:322 S COLLEGE RD # 1116
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-1632
Practice Address - Country:US
Practice Address - Phone:910-442-8188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103499103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist