Provider Demographics
NPI:1790453058
Name:SCHRODER, CHARITY (CADC-I)
Entity Type:Individual
Prefix:
First Name:CHARITY
Middle Name:
Last Name:SCHRODER
Suffix:
Gender:F
Credentials:CADC-I
Other - Prefix:
Other - First Name:CHARITY
Other - Middle Name:
Other - Last Name:KLETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2167 BRUCE ST NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-7403
Mailing Address - Country:US
Mailing Address - Phone:541-297-6982
Mailing Address - Fax:
Practice Address - Street 1:2167 BRUCE ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-7403
Practice Address - Country:US
Practice Address - Phone:541-297-6982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2022-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR21-12-10307101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)