Healthcare Provider Details

I. General information

NPI: 1841127990
Provider Name (Legal Business Name): ANGELA BEA SCHROER NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

943 9TH AVE SW
FOREST LAKE MN
55025-1761
US

IV. Provider business mailing address

13935 240TH ST N
SCANDIA MN
55073-9532
US

V. Phone/Fax

Practice location:
  • Phone: 651-982-8347
  • Fax:
Mailing address:
  • Phone: 651-503-8894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number492807
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: