Provider Demographics
NPI:1730930124
Name:SCHAEFER, JOELLE (BCABA)
Entity type:Individual
Prefix:
First Name:JOELLE
Middle Name:
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 S 4TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-1684
Mailing Address - Country:US
Mailing Address - Phone:856-404-3987
Mailing Address - Fax:
Practice Address - Street 1:2929 ARCH ST STE 1700
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-7327
Practice Address - Country:US
Practice Address - Phone:888-805-8206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0-18-8748106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst