Provider Demographics
NPI:1437564838
Name:SCHNEIDERMAN, ANNA WADDELL (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:WADDELL
Last Name:SCHNEIDERMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 WAXHAW PROFESSIONAL PARK DRIVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-9975
Mailing Address - Country:US
Mailing Address - Phone:704-769-0424
Mailing Address - Fax:704-243-0098
Practice Address - Street 1:104 WAXHAW PROFESSIONAL PARK DRIVE
Practice Address - Street 2:
Practice Address - City:WAXHAW
Practice Address - State:NC
Practice Address - Zip Code:28173
Practice Address - Country:US
Practice Address - Phone:704-769-0424
Practice Address - Fax:704-243-0098
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-24
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC010488101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health