Healthcare Provider Details
I. General information
NPI: 1760435127
Provider Name (Legal Business Name): HELEN D. SCHANDOLPH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 05/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
224 STEPHENSON AVE SUITE C
SAVANNAH GA
31405-5920
US
IV. Provider business mailing address
PO BOX 13309
SAVANNAH GA
31416-0309
US
V. Phone/Fax
- Phone: 912-355-3881
- Fax: 912-355-3887
- Phone: 912-355-3881
- Fax: 912-355-3887
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | CSW003068 |
| License Number State | GA |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: