Provider Demographics
NPI:1568527935
Name:SCHNEYER, LEE CARL (EDD)
Entity Type:Individual
Prefix:MR
First Name:LEE
Middle Name:CARL
Last Name:SCHNEYER
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11119 ROCKVILLE PIKE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852
Mailing Address - Country:US
Mailing Address - Phone:301-231-6161
Mailing Address - Fax:301-231-0129
Practice Address - Street 1:11119 ROCKVILLE PIKE
Practice Address - Street 2:SUITE 200
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852
Practice Address - Country:US
Practice Address - Phone:301-231-6161
Practice Address - Fax:301-231-0129
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1585103T00000X
MD01585103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
491903Medicare ID - Type Unspecified