Healthcare Provider Details

I. General information

NPI: 1457743031
Provider Name (Legal Business Name): KATHLEEN SCHLOEMER MA, LMFT, PMH-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHLEEN MCMILLEN MA

II. Dates (important events)

Enumeration Date: 02/19/2015
Last Update Date: 11/17/2023
Certification Date: 11/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 W ALTO RD
KOKOMO IN
46902-4907
US

IV. Provider business mailing address

702 W ALTO RD
KOKOMO IN
46902-4907
US

V. Phone/Fax

Practice location:
  • Phone: 765-453-7422
  • Fax:
Mailing address:
  • Phone: 765-453-7422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number35001983A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: