Provider Demographics
NPI:1073817912
Name:SCHNEIDER, MICHAEL (MA, LPC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 S TELEGRAPH RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0950
Mailing Address - Country:US
Mailing Address - Phone:248-322-0003
Mailing Address - Fax:
Practice Address - Street 1:33300 FIVE MILE RD
Practice Address - Street 2:SUITE 208
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-3093
Practice Address - Country:US
Practice Address - Phone:734-522-0280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-07
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401007767101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional