Basic Information
| Provider Information | |||||||||
| NPI: | 1811201049 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHNEIDER | ||||||||
| FirstName: | NICHOLAS | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1466 WATER ST | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | STEVENS POINT | ||||||||
| State: | WI | ||||||||
| PostalCode: | 544812919 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7153416672 | ||||||||
| FaxNumber: | 7153418004 | ||||||||
| Practice Location | |||||||||
| Address1: | 1466 WATER ST | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | STEVENS POINT | ||||||||
| State: | WI | ||||||||
| PostalCode: | 544812919 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7153416672 | ||||||||
| FaxNumber: | 7153418004 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2010 | ||||||||
| LastUpdateDate: | 04/30/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 4316-125 | WI | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.