Provider Demographics
NPI:1154057909
Name:SCHNECKLOTH, JANA PATRICE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:JANA
Middle Name:PATRICE
Last Name:SCHNECKLOTH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 SE PARKER DR
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-8344
Mailing Address - Country:US
Mailing Address - Phone:515-306-1030
Mailing Address - Fax:
Practice Address - Street 1:10542 JUSTIN DR
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-3730
Practice Address - Country:US
Practice Address - Phone:515-344-4148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA062461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical