Provider Demographics
NPI:1588032403
Name:SCHOENFELD, MICHELLE LEAH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:LEAH
Last Name:SCHOENFELD
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 1:1380 ROYAL PALM SQUARE BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-1077
Mailing Address - Country:US
Mailing Address - Phone:239-788-1060
Mailing Address - Fax:
Practice Address - Street 1:1380 ROYAL PALM SQUARE BLVD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-1077
Practice Address - Country:US
Practice Address - Phone:239-887-0749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-09
Last Update Date:2022-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW129441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLII804ZOtherMEDICARE PTAN
MA124521OtherLICSW