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General NPI Number Information
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NPI Number | 1750831855
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Entity Type | Organization
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Legal Business Name | MBS PSYCHOTHERAPY SERVICES, LLC
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Dates
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Enumeration Date | 10/12/2016
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Last Update Date | 09/29/2023
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Provider Practice Location Address
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Address Line | 3661 WRANGLE HILL ROAD
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City | BEAR
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State | DE
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Zip | 19701-1906
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Country | US
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Telephone | 302-444-4798
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Fax | 302-444-4727
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Provider Business Mailing Address
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Address Line | 3661 WRANGLE HILL ROAD
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City | BEAR
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State | DE
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Zip | 19701-1906
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Country | US
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Telephone | 302-444-4798
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Fax | 302-444-4727
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | MONIQUE BYERS SCHAFFSTALL
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Credential | LCSW
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Telephone | 302-668-5478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | Q1-0001361
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License Number State | DE
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