Provider Demographics
NPI:1003078775
Name:SCHNEIDER, ILENE JULIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ILENE
Middle Name:JULIE
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 ROUTE 6
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-2356
Mailing Address - Country:US
Mailing Address - Phone:845-216-0961
Mailing Address - Fax:845-225-3207
Practice Address - Street 1:COMMUNITY HEALTH AND COUNSELING SERVICES
Practice Address - Street 2:52 CHRISTIAN RIDGE ROAD
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605
Practice Address - Country:US
Practice Address - Phone:207-610-8027
Practice Address - Fax:845-225-3207
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR043885101YM0800X
MELC180021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR043885OtherLICENSE