Provider Demographics
NPI:1326040726
Name:SCHRADER, JAY CARL (LMHC, CAP)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:CARL
Last Name:SCHRADER
Suffix:
Gender:M
Credentials:LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4625 E BAY DR STE 301
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-5747
Mailing Address - Country:US
Mailing Address - Phone:727-536-0600
Mailing Address - Fax:727-451-9899
Practice Address - Street 1:4625 E BAY DR STE 301
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-5747
Practice Address - Country:US
Practice Address - Phone:727-536-0600
Practice Address - Fax:727-451-9899
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP 388101YA0400X
FLMH 4553101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)