Provider Demographics
NPI:1053138149
Name:SCHUBERT, SLOANE (LSW)
Entity type:Individual
Prefix:
First Name:SLOANE
Middle Name:
Last Name:SCHUBERT
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:PO BOX 299
Mailing Address - Street 2:
Mailing Address - City:CHINCHILLA
Mailing Address - State:PA
Mailing Address - Zip Code:18410-0299
Mailing Address - Country:US
Mailing Address - Phone:570-903-3347
Mailing Address - Fax:
Practice Address - Street 1:2455 BACK MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:SCOTRUN
Practice Address - State:PA
Practice Address - Zip Code:18355-7758
Practice Address - Country:US
Practice Address - Phone:570-216-3540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker