Provider Demographics
NPI:1104983980
Name:SCHLAUCH, RICHARD M JR (MSW, LCSW, LISW-CP)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:M
Last Name:SCHLAUCH
Suffix:JR
Gender:M
Credentials:MSW, LCSW, LISW-CP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1721 EBENEZER RD
Mailing Address - Street 2:STE 225
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-1119
Mailing Address - Country:US
Mailing Address - Phone:803-329-9639
Mailing Address - Fax:803-329-5830
Practice Address - Street 1:454 ANDERSON RD S
Practice Address - Street 2:BTC SUITE #115
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-3392
Practice Address - Country:US
Practice Address - Phone:803-329-9639
Practice Address - Fax:803-329-5830
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NCC005197101YM0800X
SC72441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6106250Medicaid
SC1104983980Medicaid
NC2852328Medicare PIN