Provider Demographics
NPI:1679520654
Name:SCHLEGEL, PAULETTE (BA, CADC I)
Entity Type:Individual
Prefix:
First Name:PAULETTE
Middle Name:
Last Name:SCHLEGEL
Suffix:
Gender:F
Credentials:BA, CADC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 N SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:KS
Mailing Address - Zip Code:67068-1552
Mailing Address - Country:US
Mailing Address - Phone:620-532-3440
Mailing Address - Fax:620-532-3440
Practice Address - Street 1:333 N MAIN ST
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:KS
Practice Address - Zip Code:67068-1335
Practice Address - Country:US
Practice Address - Phone:620-532-3440
Practice Address - Fax:620-532-3477
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS612101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)