Provider Demographics
NPI:1063474708
Name:SCHLOEMER SERVICES INC
Entity Type:Organization
Organization Name:SCHLOEMER SERVICES INC
Other - Org Name:FRED SCHLOEMER COUNSELING
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:FRED
Authorized Official - Last Name:SCHLOEMER
Authorized Official - Suffix:
Authorized Official - Credentials:EDD LCSW
Authorized Official - Phone:502-640-7533
Mailing Address - Street 1:2100 GARDINER LN
Mailing Address - Street 2:SUITE 314
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-2949
Mailing Address - Country:US
Mailing Address - Phone:502-640-7533
Mailing Address - Fax:502-473-1957
Practice Address - Street 1:2100 GARDINER LN
Practice Address - Street 2:SUITE 314
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-2949
Practice Address - Country:US
Practice Address - Phone:502-640-7533
Practice Address - Fax:502-473-1957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYCADC0408101Y00000X
KYLCSW0307104100000X
KYLMFT0095106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000371933OtherANTHEM BLUE CROSS BLUE SHIELD
KY2702553000OtherPASSPORT ADVANTAGE
KY280550OtherVALUEOPTIONS
KY82003070Medicaid
KY2702553000OtherPASSPORT ADVANTAGE