Basic Information
| Provider Information | |||||||||
| NPI: | 1922524750 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHAFER | ||||||||
| FirstName: | RENEE | ||||||||
| MiddleName: | JEWELL | ||||||||
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| Credential: | LLMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1310 TURNER STREET | ||||||||
| Address2: | SUITE A | ||||||||
| City: | LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48906 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5175744197 | ||||||||
| FaxNumber: | 5174841771 | ||||||||
| Practice Location | |||||||||
| Address1: | 1310 TURNER ST STE A | ||||||||
| Address2: | |||||||||
| City: | LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 489064373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5175744197 | ||||||||
| FaxNumber: | 5174841771 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 6801101637 | MI | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 104100000X | 6801101637 | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.