Provider Demographics
NPI:1245665793
Name:SCHACHT, LIZ CRISTINA (LCSW, MSW)
Entity type:Individual
Prefix:MRS
First Name:LIZ
Middle Name:CRISTINA
Last Name:SCHACHT
Suffix:
Gender:F
Credentials:LCSW, MSW
Other - Prefix:MRS
Other - First Name:LIZ
Other - Middle Name:CRISTINA
Other - Last Name:HOLLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:6 LAURA LN
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-2924
Mailing Address - Country:US
Mailing Address - Phone:203-506-9910
Mailing Address - Fax:
Practice Address - Street 1:6 LAURA LN
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-2924
Practice Address - Country:US
Practice Address - Phone:203-506-9910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0126931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTPENDINGMedicaid
PENDINGOtherCAQH