Provider Demographics
NPI:1700974847
Name:SCHAEFER, SHAYNA LEE (LCSW)
Entity Type:Individual
Prefix:
First Name:SHAYNA
Middle Name:LEE
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6636 W WILLIAM CANNON DR APT 1527
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-8548
Mailing Address - Country:US
Mailing Address - Phone:512-826-1033
Mailing Address - Fax:
Practice Address - Street 1:6636 W WILLIAM CANNON DR APT 1527
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-8548
Practice Address - Country:US
Practice Address - Phone:512-826-1033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-060021041C0700X
TX1074531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM10021694OtherLOVELACE
NM73726851Medicaid
NM10021694OtherLOVELACE