Provider Demographics
NPI:1598836496
Name:SCHNEIDER, GERALYN MARIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:GERALYN
Middle Name:MARIE
Last Name:SCHNEIDER
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 1:3716 21ST ST
Mailing Address - Street 2:
Mailing Address - City:GREAT BEND
Mailing Address - State:KS
Mailing Address - Zip Code:67530-7417
Mailing Address - Country:US
Mailing Address - Phone:620-793-7040
Mailing Address - Fax:
Practice Address - Street 1:3716 21ST ST
Practice Address - Street 2:
Practice Address - City:GREAT BEND
Practice Address - State:KS
Practice Address - Zip Code:67530-7417
Practice Address - Country:US
Practice Address - Phone:620-793-7040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 27391041C0700X
KS38531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ3983AMedicare PIN
KSKA1566Medicare PIN