Provider Demographics
NPI:1952022618
Name:SCHUMACHER, AMANDA (LAC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:SCHUMACHER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:MANDY
Other - Middle Name:JO
Other - Last Name:SCHUMACHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:8625 E BELLEVIEW PL UNIT 1048
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-4141
Mailing Address - Country:US
Mailing Address - Phone:307-871-6733
Mailing Address - Fax:
Practice Address - Street 1:10613 N HAYDEN RD STE J-103
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-5683
Practice Address - Country:US
Practice Address - Phone:480-485-8824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19173101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health