Healthcare Provider Details

I. General information

NPI: 1700550100
Provider Name (Legal Business Name): CHLOE SCHROEDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHLOE GEIST

II. Dates (important events)

Enumeration Date: 08/09/2021
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E GREEN ST
ITHACA NY
14850-5635
US

IV. Provider business mailing address

201 E GREEN ST
ITHACA NY
14850-5635
US

V. Phone/Fax

Practice location:
  • Phone: 607-274-6200
  • Fax:
Mailing address:
  • Phone: 607-274-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number113283
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number100021
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: