Healthcare Provider Details

I. General information

NPI: 1417495631
Provider Name (Legal Business Name): LEE SCHAEFER RN, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2017
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 COURT ST
BROOKLYN NY
11242-0103
US

IV. Provider business mailing address

207 PROSPECT PARK SW APT 4D
BROOKLYN NY
11218-1553
US

V. Phone/Fax

Practice location:
  • Phone: 973-559-7282
  • Fax:
Mailing address:
  • Phone: 201-835-7074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF407921-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number090495-01
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number910483-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: