Healthcare Provider Details

I. General information

NPI: 1154623577
Provider Name (Legal Business Name): AMANDA SCHAEFER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2010
Last Update Date: 03/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 PALMER ST
CALAIS ME
04619-1300
US

IV. Provider business mailing address

127 PALMER ST
CALAIS ME
04619-1300
US

V. Phone/Fax

Practice location:
  • Phone: 207-454-0387
  • Fax: 207-454-0232
Mailing address:
  • Phone: 207-454-0387
  • Fax: 207-454-0232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC13942
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: