Provider Demographics
NPI:1689723397
Name:HAZARD-SCHILLEBEECKX, ROSELYNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ROSELYNE
Middle Name:
Last Name:HAZARD-SCHILLEBEECKX
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 HONEY LOCUST LN
Mailing Address - Street 2:
Mailing Address - City:LABADIE
Mailing Address - State:MO
Mailing Address - Zip Code:63055-1068
Mailing Address - Country:US
Mailing Address - Phone:636-742-6901
Mailing Address - Fax:
Practice Address - Street 1:126 W MAIN ST.
Practice Address - Street 2:2ND FLOOR W
Practice Address - City:UNION
Practice Address - State:MO
Practice Address - Zip Code:63084
Practice Address - Country:US
Practice Address - Phone:636-583-9863
Practice Address - Fax:636-583-6648
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20040241331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical