Provider Demographics
NPI:1346329430
Name:SCHNEIDER, HENRY DAVID (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:DAVID
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:PHD, LCSW
Other - Prefix:DR
Other - First Name:HANK
Other - Middle Name:DAVID
Other - Last Name:SCHNEIDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD, LCSW
Mailing Address - Street 1:2804 FORUM BLVD
Mailing Address - Street 2:3A
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-6322
Mailing Address - Country:US
Mailing Address - Phone:573-446-6290
Mailing Address - Fax:573-446-0618
Practice Address - Street 1:2804 FORUM BLVD
Practice Address - Street 2:3A
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-6322
Practice Address - Country:US
Practice Address - Phone:573-446-6290
Practice Address - Fax:573-446-0618
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0006001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical