Provider Demographics
NPI:1386078251
Name:SCHAEFER, LAURIE (LSW)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 CASS ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08611-2405
Mailing Address - Country:US
Mailing Address - Phone:609-265-4200
Mailing Address - Fax:
Practice Address - Street 1:833 CASS ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08611-2405
Practice Address - Country:US
Practice Address - Phone:609-265-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-28
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05064700104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker