Provider Demographics
NPI:1649649120
Name:SCHAEDE, JACQUELINE RUTH (LPC, LMFT)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:RUTH
Last Name:SCHAEDE
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1960 E OCEAN VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23503-2504
Mailing Address - Country:US
Mailing Address - Phone:757-664-6674
Mailing Address - Fax:757-441-1152
Practice Address - Street 1:1960 EAST OCEAN VIEW AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23503-2504
Practice Address - Country:US
Practice Address - Phone:757-664-6674
Practice Address - Fax:757-441-1152
Is Sole Proprietor?:No
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002444101YP2500X
VA0717000906106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist