Provider Demographics
NPI:1811709801
Name:SCHOBERL, KATHERINE AMANDA
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:AMANDA
Last Name:SCHOBERL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 ANCLOTE RD
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-6950
Mailing Address - Country:US
Mailing Address - Phone:631-664-6639
Mailing Address - Fax:
Practice Address - Street 1:3450 E LAKE RD STE 307
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34685-2411
Practice Address - Country:US
Practice Address - Phone:727-238-5821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-25
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health