Provider Demographics
NPI:1356713630
Name:SCHAAD, SUSANA IRENE (LLMFT)
Entity type:Individual
Prefix:
First Name:SUSANA
Middle Name:IRENE
Last Name:SCHAAD
Suffix:
Gender:F
Credentials:LLMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2890 CARPENTER RD
Mailing Address - Street 2:#1600
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-1100
Mailing Address - Country:US
Mailing Address - Phone:734-667-0609
Mailing Address - Fax:734-667-3072
Practice Address - Street 1:2890 CARPENTER RD
Practice Address - Street 2:#1600
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-1100
Practice Address - Country:US
Practice Address - Phone:734-667-0609
Practice Address - Fax:734-667-3072
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-26
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4101006667106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist