=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922699255
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KAREN SCHNELLER LICENSED MARRIAGE AND FAMILY THERAPIST INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/29/2021
-----------------------------------------------------
Last Update Date | 02/14/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1530 MONTEREY ST STE A2
-----------------------------------------------------
City | SAN LUIS OBISPO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93401-2969
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-884-6827
-----------------------------------------------------
Fax | 714-362-9564
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 21 W 12TH ST
-----------------------------------------------------
City | PASO ROBLES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93446-2015
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-884-6827
-----------------------------------------------------
Fax | 714-362-9564
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | KAREN P SCHNELLER
-----------------------------------------------------
Credential | LMFT
-----------------------------------------------------
Telephone | 562-884-6827
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------