Provider Demographics
NPI:1306193362
Name:SCHNEIDER, RICHELLE I (LCSW)
Entity Type:Individual
Prefix:
First Name:RICHELLE
Middle Name:I
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:RICHELLE
Other - Middle Name:I
Other - Last Name:OHM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:339 ALANA DR
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-1766
Mailing Address - Country:US
Mailing Address - Phone:815-462-3827
Mailing Address - Fax:815-462-3837
Practice Address - Street 1:339 ALANA DR
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-1766
Practice Address - Country:US
Practice Address - Phone:815-462-3827
Practice Address - Fax:815-462-3837
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490085661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical