MEDICARE: LAUREN SCHAEFER PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	103499	NC

General Provider Information

NPI Number	:	1679190219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN SCHAEFER PHD

Provider Business Mailing Address
First Line	:	322 S COLLEGE RD # 1116
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28403-1632
Country	:	US
Telephone Number	:	910-442-8188
Fax Number	:

Provider Business Practice Location Address
First Line	:	322 S COLLEGE RD # 1116
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28403-1632
Country	:	US
Telephone Number	:	910-442-8188
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2020
Last Update Date	:	03/16/2023

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