Provider Demographics
NPI:1710214762
Name:SCHWANTES, REBCCA SUSAN (MSW, MA,)
Entity Type:Individual
Prefix:MS
First Name:REBCCA
Middle Name:SUSAN
Last Name:SCHWANTES
Suffix:
Gender:F
Credentials:MSW, MA,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6614 CLAYTON RD
Mailing Address - Street 2:#235
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1602
Mailing Address - Country:US
Mailing Address - Phone:314-361-3530
Mailing Address - Fax:
Practice Address - Street 1:6614 CLAYTON RD
Practice Address - Street 2:#235
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1602
Practice Address - Country:US
Practice Address - Phone:314-361-3530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-12
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009031354104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker