Provider Demographics
NPI:1265532741
Name:SCHADE, FREDERICK RAYMOND JR (LMSW)
Entity type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:RAYMOND
Last Name:SCHADE
Suffix:JR
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1466 W SUTTON RD
Mailing Address - Street 2:
Mailing Address - City:METAMORA
Mailing Address - State:MI
Mailing Address - Zip Code:48455-9616
Mailing Address - Country:US
Mailing Address - Phone:810-667-0500
Mailing Address - Fax:
Practice Address - Street 1:1570 SUNCREST DR
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-1154
Practice Address - Country:US
Practice Address - Phone:810-667-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010150711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI01002573OtherHEALTH PLUS OF MICHIGAN
MI1007731OtherMCLAREN HELATH PLAN
MI1007731OtherMCLAREN HEALTH ADVANTAGE
MI1705242OtherBCBSM
MI1705242OtherBCBSM