Provider Demographics
NPI:1538283593
Name:SCHNEIDER, LINDA ANN (LMSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ANN
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:LEEDY
Other - Last Name:SCHNEIDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:3520 REEDS HILL CT SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-8329
Mailing Address - Country:US
Mailing Address - Phone:616-942-7129
Mailing Address - Fax:616-285-6063
Practice Address - Street 1:2020 RAYBROOK ST SE
Practice Address - Street 2:#202
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-7717
Practice Address - Country:US
Practice Address - Phone:616-285-6777
Practice Address - Fax:616-285-6063
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010815461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOP20680Medicare ID - Type UnspecifiedMEDICARE