Provider Demographics
NPI:1821628116
Name:SCHNEIDER, MACKENZIE (PHD)
Entity type:Individual
Prefix:DR
First Name:MACKENZIE
Middle Name:
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26657 WOODWARD AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48070-1300
Mailing Address - Country:US
Mailing Address - Phone:248-572-3390
Mailing Address - Fax:
Practice Address - Street 1:26657 WOODWARD AVE STE 100
Practice Address - Street 2:
Practice Address - City:HUNTINGTON WOODS
Practice Address - State:MI
Practice Address - Zip Code:48070-1300
Practice Address - Country:US
Practice Address - Phone:248-572-3390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-25
Last Update Date:2025-07-15
Deactivation Date:2020-12-14
Deactivation Code:
Reactivation Date:2023-01-27
Provider Licenses
StateLicense IDTaxonomies
MI6301018903103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical