Healthcare Provider Details

I. General information

NPI: 1124573241
Provider Name (Legal Business Name): ALEXIS ANN SCHNEIDER LLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2016
Last Update Date: 08/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 N CEDAR ST 200B
LANSING MI
48906-5334
US

IV. Provider business mailing address

1106 N CEDAR ST 200B
LANSING MI
48906-5334
US

V. Phone/Fax

Practice location:
  • Phone: 720-500-5433
  • Fax:
Mailing address:
  • Phone: 720-500-5433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401015081
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number51630
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number00118070
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: