Provider Demographics
NPI:1851477723
Name:SCHRADER, MARSELLA KAY (LMHC)
Entity Type:Individual
Prefix:DR
First Name:MARSELLA
Middle Name:KAY
Last Name:SCHRADER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8935 N MERIDIAN ST #107
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260
Mailing Address - Country:US
Mailing Address - Phone:317-571-0170
Mailing Address - Fax:317-571-2005
Practice Address - Street 1:8935 N MERIDIAN ST STE 107
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5348
Practice Address - Country:US
Practice Address - Phone:317-571-0170
Practice Address - Fax:317-571-2005
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39001326A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health