Provider Demographics
NPI:1790457232
Name:SCHOENLEIN, JULIE (LISW-S)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:SCHOENLEIN
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20033 DETROIT RD STE G
Mailing Address - Street 2:NORTH RIDGE ANNEX
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-2400
Mailing Address - Country:US
Mailing Address - Phone:330-421-7814
Mailing Address - Fax:
Practice Address - Street 1:20033 DETROIT RD STE G
Practice Address - Street 2:NORTH RIDGE ANNEX
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-2400
Practice Address - Country:US
Practice Address - Phone:330-421-7814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-04
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.11016121041C0700X
OHI1101612104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0464236Medicaid