Provider Demographics
NPI:1962712554
Name:SCHWEBACH, KAY MARIE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:KAY
Middle Name:MARIE
Last Name:SCHWEBACH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1465 ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ST PAUL PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55071-1470
Mailing Address - Country:US
Mailing Address - Phone:651-336-0005
Mailing Address - Fax:
Practice Address - Street 1:1976 WOODDALE DR
Practice Address - Street 2:SUITE 4
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-4358
Practice Address - Country:US
Practice Address - Phone:651-735-9534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1904106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist