Provider Demographics
NPI:1922133586
Name:SCHLOEMANN, MARK M (MSW,LCSW)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:M
Last Name:SCHLOEMANN
Suffix:
Gender:M
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 W HERRIN ST
Mailing Address - Street 2:
Mailing Address - City:HERRIN
Mailing Address - State:IL
Mailing Address - Zip Code:62948-6433
Mailing Address - Country:US
Mailing Address - Phone:618-988-8267
Mailing Address - Fax:618-529-4477
Practice Address - Street 1:1400 W MAIN ST
Practice Address - Street 2:SUITE 14
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62901-2276
Practice Address - Country:US
Practice Address - Phone:618-457-7621
Practice Address - Fax:618-529-4477
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical