MEDICARE: MS. LARA SCHAEFFER M.ED. C.A.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1467237545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LARA SCHAEFFER M.ED. C.A.S.

Provider Business Mailing Address
First Line	:	350 SPRINGFIELD AVE STE 200
Second Line	:
City	:	SUMMIT
State	:	NJ
Zip	:	07901-4610
Country	:	US
Telephone Number	:	201-787-7721
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 SPRINGFIELD AVE STE 200
Second Line	:
City	:	SUMMIT
State	:	NJ
Zip	:	07901-4610
Country	:	US
Telephone Number	:	201-787-7721
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2023
Last Update Date	:	08/28/2023

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