Provider Demographics
NPI:1932419652
Name:SCHAFER, JOANN MILDRED (LLMSW)
Entity Type:Individual
Prefix:MS
First Name:JOANN
Middle Name:MILDRED
Last Name:SCHAFER
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4593 SUNSET DRIVE
Mailing Address - Street 2:
Mailing Address - City:POTTERVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48876
Mailing Address - Country:US
Mailing Address - Phone:517-980-0411
Mailing Address - Fax:
Practice Address - Street 1:710 W. LAWRENCE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:MI
Practice Address - Zip Code:48876
Practice Address - Country:US
Practice Address - Phone:517-543-1150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010924391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical