Provider Demographics
NPI:1821264102
Name:SCHAPER, KIRSTEN LYN (CCC-SLP, BCBA)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:LYN
Last Name:SCHAPER
Suffix:
Gender:F
Credentials:CCC-SLP, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 BLUEBERRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:COBDEN
Mailing Address - State:IL
Mailing Address - Zip Code:62920-3443
Mailing Address - Country:US
Mailing Address - Phone:618-697-2138
Mailing Address - Fax:
Practice Address - Street 1:3022 S PARK AVE
Practice Address - Street 2:
Practice Address - City:HERRIN
Practice Address - State:IL
Practice Address - Zip Code:62948-3721
Practice Address - Country:US
Practice Address - Phone:618-967-1567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.007980235Z00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist