Provider Demographics
NPI:1336577758
Name:SCHECKEL, IRA LEIGHANN
Entity Type:Individual
Prefix:MRS
First Name:IRA
Middle Name:LEIGHANN
Last Name:SCHECKEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:IRA
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3520 E RIVER RD NE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55906-5407
Mailing Address - Country:US
Mailing Address - Phone:507-258-3287
Mailing Address - Fax:
Practice Address - Street 1:3520 E RIVER RD NE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55906-5407
Practice Address - Country:US
Practice Address - Phone:507-216-3841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-22
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X
MNLPC-2326101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional