Provider Demographics
NPI:1851425581
Name:SCHAFER, JON B (MS, LPC, NCC, MAC)
Entity Type:Individual
Prefix:MR
First Name:JON
Middle Name:B
Last Name:SCHAFER
Suffix:
Gender:M
Credentials:MS, LPC, NCC, MAC
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9300 DEWITT LOOP
Mailing Address - Street 2:FORT BELVOIR COMMUNITY HOSPITAL
Mailing Address - City:FORT BELVOIR
Mailing Address - State:VA
Mailing Address - Zip Code:22060-5285
Mailing Address - Country:US
Mailing Address - Phone:571-231-1171
Mailing Address - Fax:571-231-1172
Practice Address - Street 1:9300 DEWITT LOOP
Practice Address - Street 2:CHILD AND ADOLESCENT PSYCHIATRY SERVICES CLINIC
Practice Address - City:FORT BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060-5285
Practice Address - Country:US
Practice Address - Phone:571-231-1171
Practice Address - Fax:571-231-1172
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2315101YA0400X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL11713524OtherCAQH
AL51527447OtherBCBSAL
AL200280923OtherTAX ID
AL51534981OtherAMERICAN BEHAVIORAL HEALT