Provider Demographics
NPI:1467652545
Name:SCHNEIDER, KRISTENE M (LMSW)
Entity type:Individual
Prefix:
First Name:KRISTENE
Middle Name:M
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KRISTENE
Other - Middle Name:M
Other - Last Name:DERMODY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:4000 WELLNESS DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48670-2000
Mailing Address - Country:US
Mailing Address - Phone:844-832-1956
Mailing Address - Fax:989-633-5241
Practice Address - Street 1:602 BEECH ST STE 3100
Practice Address - Street 2:
Practice Address - City:CLARE
Practice Address - State:MI
Practice Address - Zip Code:48617-1467
Practice Address - Country:US
Practice Address - Phone:989-802-5058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010804931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical