Provider Demographics
NPI:1619303278
Name:SANDRA SCHOPMEYER LMSW
Entity Type:Organization
Organization Name:SANDRA SCHOPMEYER LMSW
Other - Org Name:SANDRA SCHOPMEYER PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOPMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:517-789-7885
Mailing Address - Street 1:1214 COOPER ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-2496
Mailing Address - Country:US
Mailing Address - Phone:517-789-7885
Mailing Address - Fax:
Practice Address - Street 1:1214 COOPER ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-2496
Practice Address - Country:US
Practice Address - Phone:517-789-7885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801088931251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health