Healthcare Provider Details

I. General information

NPI: 1801168257
Provider Name (Legal Business Name): SUZANNE MARIE SCHAEFFER LPC, MC, NCC, CCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2012
Last Update Date: 02/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62 FRANKLIN ST
HAZLETON PA
18201-6825
US

IV. Provider business mailing address

62 FRANKLIN ST
HAZLETON PA
18201-6825
US

V. Phone/Fax

Practice location:
  • Phone: 570-401-5822
  • Fax:
Mailing address:
  • Phone: 570-401-5822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC001468
License Number StatePA

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: