Provider Demographics
NPI:1003531005
Name:C SCHROEDER PSYCH SC
Entity Type:Organization
Organization Name:C SCHROEDER PSYCH SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CALLIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:920-901-8360
Mailing Address - Street 1:1430 WESTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-1604
Mailing Address - Country:US
Mailing Address - Phone:920-901-8360
Mailing Address - Fax:
Practice Address - Street 1:1020 MARITIME DR
Practice Address - Street 2:
Practice Address - City:MANITOWOC
Practice Address - State:WI
Practice Address - Zip Code:54220-2922
Practice Address - Country:US
Practice Address - Phone:920-769-0152
Practice Address - Fax:920-769-0153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty