Healthcare Provider Details

I. General information

NPI: 1003810912
Provider Name (Legal Business Name): VICTORIA MARIE SCHREIBER M.A., L.M.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2005
Last Update Date: 10/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7383 RADCLIFF DR
WEST BLOOMFIELD MI
48322-3534
US

IV. Provider business mailing address

7383 RADCLIFF DR
WEST BLOOMFIELD MI
48322-3534
US

V. Phone/Fax

Practice location:
  • Phone: 248-476-4515
  • Fax: 248-661-8810
Mailing address:
  • Phone: 248-476-4515
  • Fax: 248-661-8810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401003601
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801034974
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: