Healthcare Provider Details

I. General information

NPI: 1821214305
Provider Name (Legal Business Name): SUSAN P SCHWEDER LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SUSAN SCHWEDER BELL

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 N WINTER ST
MIDWAY KY
40347-1115
US

IV. Provider business mailing address

425 N WINTER ST
MIDWAY KY
40347-1115
US

V. Phone/Fax

Practice location:
  • Phone: 859-846-4346
  • Fax: 859-846-4346
Mailing address:
  • Phone: 859-846-4346
  • Fax: 859-846-4346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberKY-0457
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: