Healthcare Provider Details

I. General information

NPI: 1598223455
Provider Name (Legal Business Name): HEATHER E SCHNEIDER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2019
Last Update Date: 03/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 FEMRITE DR
MONONA WI
53716-3798
US

IV. Provider business mailing address

5722 OXBOW BND
MADISON WI
53716-2472
US

V. Phone/Fax

Practice location:
  • Phone: 608-222-7311
  • Fax:
Mailing address:
  • Phone: 608-485-2771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number6145-125
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6145-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: