Healthcare Provider Details

I. General information

NPI: 1649910084
Provider Name (Legal Business Name): BONNIE JOY SCHNEIDER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. BONNIE JOY PACKER

II. Dates (important events)

Enumeration Date: 04/01/2022
Last Update Date: 04/30/2024
Certification Date: 04/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

336 WEST PASSAIC STREET
ROCHELLE PARK NJ
07662-3027
US

IV. Provider business mailing address

336 WEST PASSAIC STREET
ROCHELLE PARK NJ
07662-3027
US

V. Phone/Fax

Practice location:
  • Phone: 201-845-7030
  • Fax: 201-845-0899
Mailing address:
  • Phone: 201-845-7030
  • Fax: 201-845-0899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number44SC05695600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: