Provider Demographics
NPI:1497124226
Name:SCHNEIDER, ANGIE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:ANGIE
Middle Name:
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 E LONGVIEW DR
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-2167
Mailing Address - Country:US
Mailing Address - Phone:920-234-9240
Mailing Address - Fax:920-364-6096
Practice Address - Street 1:424 E LONGVIEW DR
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-2167
Practice Address - Country:US
Practice Address - Phone:920-234-9240
Practice Address - Fax:920-364-6096
Is Sole Proprietor?:No
Enumeration Date:2015-09-22
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2678-226101Y00000X
WI6993101Y00000X
WI6993-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100064797Medicaid