Provider Demographics
NPI:1386077204
Name:SCHAAT, ERIC M (LCSW)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:M
Last Name:SCHAAT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3858
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83403-3858
Mailing Address - Country:US
Mailing Address - Phone:208-529-1660
Mailing Address - Fax:208-529-1699
Practice Address - Street 1:3522 BRIAR CREEK LN
Practice Address - Street 2:
Practice Address - City:AMMON
Practice Address - State:ID
Practice Address - Zip Code:83406-4728
Practice Address - Country:US
Practice Address - Phone:208-529-1660
Practice Address - Fax:208-529-1699
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-14
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-388731041C0700X
IDLMSW-28609104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker