Provider Demographics
NPI:1659434686
Name:SCHAMMEL, KIM M (LCSW)
Entity type:Individual
Prefix:MS
First Name:KIM
Middle Name:M
Last Name:SCHAMMEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 S MCQUEEN RD
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-6002
Mailing Address - Country:US
Mailing Address - Phone:480-497-0742
Mailing Address - Fax:480-813-6809
Practice Address - Street 1:245 S MCQUEEN RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-6002
Practice Address - Country:US
Practice Address - Phone:480-497-0742
Practice Address - Fax:480-813-6809
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-108711041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool