Provider Demographics
NPI:1093212185
Name:LOUIS-SCHNAKENBERG, MICHELLE DIANE (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:DIANE
Last Name:LOUIS-SCHNAKENBERG
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7409 W COUNTRY CLUB BLVD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-1451
Mailing Address - Country:US
Mailing Address - Phone:561-302-5606
Mailing Address - Fax:
Practice Address - Street 1:7409 W COUNTRY CLUB BLVD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1451
Practice Address - Country:US
Practice Address - Phone:561-302-5606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-06
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11921101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH11921OtherSTATE OF FLORIDA DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE