Provider Demographics
NPI:1619936770
Name:SCHLOEMER, LEWIS FRED (EDD LCSW LMPT CADC)
Entity Type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:FRED
Last Name:SCHLOEMER
Suffix:
Gender:M
Credentials:EDD LCSW LMPT CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 GARDINER LN
Mailing Address - Street 2:SUITE 314
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-2949
Mailing Address - Country:US
Mailing Address - Phone:502-640-7533
Mailing Address - Fax:502-473-1957
Practice Address - Street 1:2100 GARDINER LN
Practice Address - Street 2:SUITE 314
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-2949
Practice Address - Country:US
Practice Address - Phone:502-640-7533
Practice Address - Fax:502-473-1957
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-18
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0408CADC101Y00000X
KY0307LCSW104100000X
KY0095LMFT106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000371933OtherANTHEM BLUE CROSS BLUE SHIELD
KY82003070Medicaid
KY280550OtherVALUEOPTIONS
KY2702560000OtherPASSPORT ADVANTAGE
KY82003070Medicaid