Provider Demographics
NPI:1255610333
Name:GENE SCHADLER, LCSW, LLC
Entity type:Organization
Organization Name:GENE SCHADLER, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW, LLC
Authorized Official - Prefix:
Authorized Official - First Name:GENE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHADLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-491-7739
Mailing Address - Street 1:6221 PHYSICIANS CT
Mailing Address - Street 2:SUITE 2
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-4031
Mailing Address - Country:US
Mailing Address - Phone:812-491-7739
Mailing Address - Fax:812-491-8095
Practice Address - Street 1:6221 PHYSICIANS CT
Practice Address - Street 2:SUITE 2
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-4031
Practice Address - Country:US
Practice Address - Phone:812-491-7739
Practice Address - Fax:812-491-8095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-08
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34003229A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1558399428OtherNPI, TYPE 1