Provider Demographics
NPI:1851487011
Name:SCHUCKER, CARRIE LEE (PHD LICENSED MFT)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:LEE
Last Name:SCHUCKER
Suffix:
Gender:F
Credentials:PHD LICENSED MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 DEL RIO PLACE
Mailing Address - Street 2:SUITE C
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616
Mailing Address - Country:US
Mailing Address - Phone:530-758-9175
Mailing Address - Fax:
Practice Address - Street 1:2727 DEL RIO PLACE
Practice Address - Street 2:SUITE C
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616
Practice Address - Country:US
Practice Address - Phone:530-758-9175
Practice Address - Fax:530-758-4239
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAM16609106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist