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General NPI Number Information
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NPI Number | 1124827332
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Entity Type | Individual
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Provider Name | KEVIN SCHAFER PH.D
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Gender | Male
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 16 POMPTON AVE
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City | POMPTON LAKES
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State | NJ
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Zip | 07442-1895
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Country | US
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Telephone | 973-835-6337
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Fax |
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Provider Business Mailing Address
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Address Line | 11 WILSON AVE E
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City | RIVERDALE
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State | NJ
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Zip | 07457-1307
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Country | US
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Telephone | 862-202-4223
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 37AC00794700
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License Number State | NJ
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