=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801396882
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SCHAEFFLER & ASSOCIATES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/16/2018
-----------------------------------------------------
Last Update Date | 02/16/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 133 BROWNS TRACE RD
-----------------------------------------------------
City | JERICHO
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05465-2034
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-839-9380
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 14
-----------------------------------------------------
City | JERICHO
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05465-0014
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | AMBER SCHAEFFLER
-----------------------------------------------------
Credential | LICSW
-----------------------------------------------------
Telephone | 802-839-9380
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | VT
-----------------------------------------------------