Provider Demographics
NPI:1205564523
Name:SCHAFER, JEFFERY (LISW)
Entity type:Individual
Prefix:
First Name:JEFFERY
Middle Name:
Last Name:SCHAFER
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1486 FORESTBROOK LN
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-1214
Mailing Address - Country:US
Mailing Address - Phone:330-620-5957
Mailing Address - Fax:
Practice Address - Street 1:1486 FORESTBROOK LN
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-1214
Practice Address - Country:US
Practice Address - Phone:330-620-5957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-14
Last Update Date:2022-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.2102751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical