Provider Demographics
NPI:1104917699
Name:SCHOENBERGER, LUCILLE RUTH (LCSW)
Entity type:Individual
Prefix:
First Name:LUCILLE
Middle Name:RUTH
Last Name:SCHOENBERGER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CICI
Other - Middle Name:CONTI
Other - Last Name:SCHOENBERGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CAS
Mailing Address - Street 1:HC 89 BOX 8190
Mailing Address - Street 2:
Mailing Address - City:TALKEETNA
Mailing Address - State:AK
Mailing Address - Zip Code:99676-9701
Mailing Address - Country:US
Mailing Address - Phone:907-733-2273
Mailing Address - Fax:907-733-1735
Practice Address - Street 1:HC 89 BOX 8190
Practice Address - Street 2:
Practice Address - City:TALKEETNA
Practice Address - State:AK
Practice Address - Zip Code:99676-9701
Practice Address - Country:US
Practice Address - Phone:907-733-2273
Practice Address - Fax:907-733-1735
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK9411041C0700X
MA1069301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical