Provider Demographics
NPI:1801817812
Name:SCHREIBER, TOBIAS SAMUEL (MA, LPC)
Entity type:Individual
Prefix:
First Name:TOBIAS
Middle Name:SAMUEL
Last Name:SCHREIBER
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 POWDERHORN RD
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-3399
Mailing Address - Country:US
Mailing Address - Phone:864-963-3421
Mailing Address - Fax:864-967-8617
Practice Address - Street 1:20 POWDERHORN RD
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-3399
Practice Address - Country:US
Practice Address - Phone:864-963-3421
Practice Address - Fax:864-967-8617
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC866101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC301100Medicaid
SC301100Medicaid