Provider Demographics
NPI:1609084193
Name:SCHOENTHAL, AUDREY ANN (LMFT, LMHC)
Entity Type:Individual
Prefix:MS
First Name:AUDREY
Middle Name:ANN
Last Name:SCHOENTHAL
Suffix:
Gender:F
Credentials:LMFT, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 22ND ST
Mailing Address - Street 2:
Mailing Address - City:SPIRIT LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:51360-1521
Mailing Address - Country:US
Mailing Address - Phone:712-336-2298
Mailing Address - Fax:
Practice Address - Street 1:1403 18TH ST.
Practice Address - Street 2:
Practice Address - City:SPIRIT LAKE
Practice Address - State:IA
Practice Address - Zip Code:51360
Practice Address - Country:US
Practice Address - Phone:712-336-8898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00184106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist