MEDICARE: MRS. MICHELLE LEAH SCHOENFELD LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW12944	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	II804Z	OTHER	FL	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	124521	OTHER	MA	LICSW

General Provider Information

NPI Number	:	1588032403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELLE LEAH SCHOENFELD LCSW

Provider Business Mailing Address
First Line	:	1380 ROYAL PALM SQUARE BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-1077
Country	:	US
Telephone Number	:	239-788-1060
Fax Number	:

Provider Business Practice Location Address
First Line	:	1380 ROYAL PALM SQUARE BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-1077
Country	:	US
Telephone Number	:	239-887-0749
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2015
Last Update Date	:	02/27/2022

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Directions to “ MRS. MICHELLE LEAH SCHOENFELD LCSW” Practice Location

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