Provider Demographics
NPI:1396774733
Name:SCHAFFER, KATHERINE JOHANNA (LCSW-R)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:JOHANNA
Last Name:SCHAFFER
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 FORT HILL AVE
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1159
Mailing Address - Country:US
Mailing Address - Phone:585-393-7500
Mailing Address - Fax:
Practice Address - Street 1:400 FORT HILL AVE (GEC-400)
Practice Address - Street 2:VETERANS ADMINSITRATION MEDICAL CENTER
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424
Practice Address - Country:US
Practice Address - Phone:585-393-7500
Practice Address - Fax:585-393-8334
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0358601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical