Provider Demographics
NPI:1831403336
Name:SCHADEWALD, SARAH DANIELLE (LCSW)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:DANIELLE
Last Name:SCHADEWALD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:DANIELLE
Other - Last Name:JORGENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1846 E INNOVATION PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85755-1963
Mailing Address - Country:US
Mailing Address - Phone:813-344-2217
Mailing Address - Fax:
Practice Address - Street 1:1846 E INNOVATION PARK DR STE 100
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755-1963
Practice Address - Country:US
Practice Address - Phone:813-344-2217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-27
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW193381041C0700X
NCC0153911041C0700X
WALW613894621041C0700X
COCSW.099242391041C0700X
MI680109201491041C0700X
AZLCSW-214271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1708146Medicaid