Provider Demographics
NPI:1891858544
Name:SCHENCK, VIRGINIA B (LPC)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:B
Last Name:SCHENCK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:VIRGINIA
Other - Middle Name:B
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:304 ROANOKE DR
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63383-1310
Mailing Address - Country:US
Mailing Address - Phone:636-456-8144
Mailing Address - Fax:
Practice Address - Street 1:734 W MONROE ST
Practice Address - Street 2:
Practice Address - City:MEXICO
Practice Address - State:MO
Practice Address - Zip Code:65265-1970
Practice Address - Country:US
Practice Address - Phone:573-582-0292
Practice Address - Fax:573-581-6036
Is Sole Proprietor?:No
Enumeration Date:2006-12-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002020611101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO194692OtherBLUE CROSS