Provider Demographics
NPI:1750346193
Name:EVANS-SCHAEFFER, HOLLY ELISE (PHD, CAC DIPLOMATE)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:ELISE
Last Name:EVANS-SCHAEFFER
Suffix:
Gender:F
Credentials:PHD, CAC DIPLOMATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 304
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19444-0304
Mailing Address - Country:US
Mailing Address - Phone:215-317-2577
Mailing Address - Fax:610-238-0709
Practice Address - Street 1:433 GERMANTOWN PIKE
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:LAFAYETTE HILL
Practice Address - State:PA
Practice Address - Zip Code:19444-1815
Practice Address - Country:US
Practice Address - Phone:215-317-2577
Practice Address - Fax:610-238-0709
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS009056L103T00000X, 103TA0400X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling