Provider Demographics
NPI:1619939170
Name:SCHOEN, JILLIAN E RYAN (LCSWR)
Entity Type:Individual
Prefix:MS
First Name:JILLIAN
Middle Name:E RYAN
Last Name:SCHOEN
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 MAIN ST
Mailing Address - Street 2:STE 207
Mailing Address - City:WILIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221
Mailing Address - Country:US
Mailing Address - Phone:716-633-6900
Mailing Address - Fax:716-633-6902
Practice Address - Street 1:5500 MAIN ST
Practice Address - Street 2:SUITE 207
Practice Address - City:WILIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221
Practice Address - Country:US
Practice Address - Phone:716-633-6900
Practice Address - Fax:716-633-6902
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR032337-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical