Healthcare Provider Details

I. General information

NPI: 1396298436
Provider Name (Legal Business Name): TERRA LINDA SCHAAD LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2016
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12051 N 96TH ST
SCOTTSDALE AZ
85260-5913
US

IV. Provider business mailing address

12051 N 96TH ST
SCOTTSDALE AZ
85260-5913
US

V. Phone/Fax

Practice location:
  • Phone: 480-393-0870
  • Fax: 480-626-4134
Mailing address:
  • Phone: 480-510-6296
  • Fax: 480-626-4134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-21990
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLAC- 12676
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: