Provider Demographics
NPI:1720868367
Name:SCHUCHARDT, ALLISON
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:SCHUCHARDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALLY
Other - Middle Name:
Other - Last Name:NASH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:2420 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-6000
Mailing Address - Country:US
Mailing Address - Phone:812-987-5039
Mailing Address - Fax:
Practice Address - Street 1:2420 E 10TH ST
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-6000
Practice Address - Country:US
Practice Address - Phone:812-987-5039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99121079A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty