Provider Demographics
NPI:1154623171
Name:SCHOONMAKER, JON (LPC)
Entity type:Individual
Prefix:
First Name:JON
Middle Name:
Last Name:SCHOONMAKER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2803 DAWN DR
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-9109
Mailing Address - Country:US
Mailing Address - Phone:517-902-1754
Mailing Address - Fax:
Practice Address - Street 1:2000 CURTIS RD
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-1752
Practice Address - Country:US
Practice Address - Phone:517-902-1754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401010892101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor