Provider Demographics
NPI:1871021964
Name:SCHAFFNER, REBECCA MARIA (LGPC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:MARIA
Last Name:SCHAFFNER
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 FITZGERALD CT APT H
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-2196
Mailing Address - Country:US
Mailing Address - Phone:301-254-9518
Mailing Address - Fax:
Practice Address - Street 1:305 W CHESAPEAKE AVE STE 501
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-9936
Practice Address - Country:US
Practice Address - Phone:301-254-9518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-01
Last Update Date:2017-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP7898101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional