Provider Demographics
NPI:1770290454
Name:SCHOONOVER, DAVID (CFT)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:SCHOONOVER
Suffix:
Gender:M
Credentials:CFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8056 KINGS GUARD ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-6326
Mailing Address - Country:US
Mailing Address - Phone:903-316-3142
Mailing Address - Fax:
Practice Address - Street 1:8056 KINGS GUARD ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89139-6326
Practice Address - Country:US
Practice Address - Phone:903-316-3142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX210760101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX210760OtherNATIONAL INSTITUTE OF HEALTH