Healthcare Provider Details

I. General information

NPI: 1497238117
Provider Name (Legal Business Name): JOSIE KLEINERT SCHAFER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2018
Last Update Date: 09/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2206 MITCHELL PARK DR STE 10
PETOSKEY MI
49770-8674
US

IV. Provider business mailing address

1470 BLACKBIRD RD
PETOSKEY MI
49770-9711
US

V. Phone/Fax

Practice location:
  • Phone: 231-487-6076
  • Fax: 231-487-6569
Mailing address:
  • Phone: 231-758-2233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401016169
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: