Provider Demographics
NPI:1023562253
Name:SCHROEDER, RON L
Entity Type:Individual
Prefix:
First Name:RON
Middle Name:L
Last Name:SCHROEDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 S 40TH ST STE 312
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-5247
Mailing Address - Country:US
Mailing Address - Phone:402-475-5069
Mailing Address - Fax:402-475-2350
Practice Address - Street 1:1919 S 40TH ST STE 312
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5247
Practice Address - Country:US
Practice Address - Phone:402-476-2300
Practice Address - Fax:402-476-2337
Is Sole Proprietor?:No
Enumeration Date:2016-08-04
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2302101YP2500X
NE4793101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional