Provider Demographics
NPI:1316136732
Name:SCHNEPPER, ANGEL DARLENE (LPC/MHSP)
Entity type:Individual
Prefix:MRS
First Name:ANGEL
Middle Name:DARLENE
Last Name:SCHNEPPER
Suffix:
Gender:F
Credentials:LPC/MHSP
Other - Prefix:MISS
Other - First Name:ANGEL
Other - Middle Name:DARLENE
Other - Last Name:FAIRBANKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC/MHSP
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-0190
Mailing Address - Country:US
Mailing Address - Phone:731-642-7802
Mailing Address - Fax:731-642-7804
Practice Address - Street 1:1027 MINERAL WELLS AVE STE 7
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-4905
Practice Address - Country:US
Practice Address - Phone:731-642-7802
Practice Address - Fax:731-642-7804
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-22
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2089101YM0800X, 101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1515644Medicaid