Provider Demographics
NPI:1750831855
Name:MBS PSYCHOTHERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:MBS PSYCHOTHERAPY SERVICES, LLC
Other - Org Name:MONIQUE BYERS SCHAFFSTALL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:BYERS SCHAFFSTALL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:302-668-5478
Mailing Address - Street 1:3661 WRANGLE HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-1906
Mailing Address - Country:US
Mailing Address - Phone:302-444-4798
Mailing Address - Fax:302-444-4727
Practice Address - Street 1:3661 WRANGLE HILL ROAD
Practice Address - Street 2:
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-1906
Practice Address - Country:US
Practice Address - Phone:302-444-4798
Practice Address - Fax:302-444-4727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-12
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00013611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty