Provider Demographics
NPI:1780795260
Name:SCHONBERG, ILA J (LMSW)
Entity type:Individual
Prefix:
First Name:ILA
Middle Name:J
Last Name:SCHONBERG
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ILA
Other - Middle Name:J
Other - Last Name:KRAUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:29941 NORTHBROOK ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2328
Mailing Address - Country:US
Mailing Address - Phone:248-851-6532
Mailing Address - Fax:
Practice Address - Street 1:30701 WOODWARD AVE
Practice Address - Street 2:#200
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-0987
Practice Address - Country:US
Practice Address - Phone:248-288-9645
Practice Address - Fax:248-288-1362
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010133291041C0700X
MI4101005557106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0Q26426 247Medicare PIN