Provider Demographics
NPI:1790443844
Name:SCHAUBACH COUNSELING AND CONSULTING, LLC
Entity Type:Organization
Organization Name:SCHAUBACH COUNSELING AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAUBACH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:757-406-4882
Mailing Address - Street 1:8157 CRITTENDEN RD
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23436-1231
Mailing Address - Country:US
Mailing Address - Phone:757-406-4882
Mailing Address - Fax:
Practice Address - Street 1:8157 CRITTENDEN RD
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23436-1231
Practice Address - Country:US
Practice Address - Phone:757-406-4882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000OtherLPC (NON-PARTICIPATING PROVIDER OF MEDICARE)