Provider Demographics
NPI:1023026952
Name:SCHNEIDER-JOHNSEN, GWEN B (PSYD,LPC,MA,ATR-BC)
Entity Type:Individual
Prefix:DR
First Name:GWEN
Middle Name:B
Last Name:SCHNEIDER-JOHNSEN
Suffix:
Gender:F
Credentials:PSYD,LPC,MA,ATR-BC
Other - Prefix:DR
Other - First Name:GWEN
Other - Middle Name:B
Other - Last Name:JOHNSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD,LPC
Mailing Address - Street 1:47 RECKLESS PL
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1750
Mailing Address - Country:US
Mailing Address - Phone:908-489-2683
Mailing Address - Fax:
Practice Address - Street 1:47 RECKLESS PL
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1750
Practice Address - Country:US
Practice Address - Phone:908-489-2683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC0064500101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor