Provider Demographics
NPI:1154372209
Name:SCHAAD, JANICE A (MSW LCSW)
Entity type:Individual
Prefix:MS
First Name:JANICE
Middle Name:A
Last Name:SCHAAD
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 326
Mailing Address - Street 2:POB 326
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82003-0326
Mailing Address - Country:US
Mailing Address - Phone:307-630-4688
Mailing Address - Fax:307-637-2899
Practice Address - Street 1:2622 PIONEER AVE
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3024
Practice Address - Country:US
Practice Address - Phone:307-763-0468
Practice Address - Fax:307-637-2899
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY4101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00368425OtherMEDICARE RAILROAD
WY123007700Medicaid
WYW21034Medicare UPIN