Provider Demographics
NPI:1326007923
Name:SCHNEIDER, EILEEN NATAL (LCSW)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:NATAL
Last Name:SCHNEIDER
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Gender:F
Credentials:LCSW
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Mailing Address - Street 1:2000 FRONTIS PLAZA BLVD STE 200
Mailing Address - Street 2:(ATTN) FORSYTH MEDICAL GROUP
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-5616
Mailing Address - Country:US
Mailing Address - Phone:336-277-2435
Mailing Address - Fax:336-277-9275
Practice Address - Street 1:250 CHARLOIS BLVD
Practice Address - Street 2:DBA WINSTON-SALEM HEALTHCARE
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1508
Practice Address - Country:US
Practice Address - Phone:336-718-1004
Practice Address - Fax:336-718-1061
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NCC0010751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890294YMedicaid
NC890294YMedicaid