Provider Demographics
NPI:1679611172
Name:SCHOENHERR, CORNELIA ELFRIEDE (MSW)
Entity Type:Individual
Prefix:MS
First Name:CORNELIA
Middle Name:ELFRIEDE
Last Name:SCHOENHERR
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:CORY
Other - Middle Name:ELFRIEDE
Other - Last Name:SCHOENHERR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:2320 MARYWOOD
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073
Mailing Address - Country:US
Mailing Address - Phone:248-588-4272
Mailing Address - Fax:
Practice Address - Street 1:2881 MONROE
Practice Address - Street 2:#203
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124
Practice Address - Country:US
Practice Address - Phone:313-791-8994
Practice Address - Fax:313-791-8994
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010206811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOM51910Medicare ID - Type Unspecified