Basic Information
| Provider Information | |||||||||
| NPI: | 1255610333 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GENE SCHADLER, LCSW, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6221 PHYSICIANS CT | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | EVANSVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 477154031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8124917739 | ||||||||
| FaxNumber: | 8124918095 | ||||||||
| Practice Location | |||||||||
| Address1: | 6221 PHYSICIANS CT | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | EVANSVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 477154031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8124917739 | ||||||||
| FaxNumber: | 8124918095 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2011 | ||||||||
| LastUpdateDate: | 08/08/2011 | ||||||||
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| AuthorizedOfficialLastName: | SCHADLER | ||||||||
| AuthorizedOfficialFirstName: | GENE | ||||||||
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| AuthorizedOfficialTitleorPosition: | LCSW, LLC | ||||||||
| AuthorizedOfficialTelephone: | 8124917739 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 34003229A | IN | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 1558399428 | 01 | IN | NPI, TYPE 1 | OTHER |