Provider Demographics
NPI:1275350795
Name:SCHRADER, MELODY (LCPC)
Entity type:Individual
Prefix:
First Name:MELODY
Middle Name:
Last Name:SCHRADER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:ALIGNED
Other - Middle Name:MIND
Other - Last Name:COUNSELING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LLC
Mailing Address - Street 1:1887 IRON CREEK RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MT
Mailing Address - Zip Code:59935-9585
Mailing Address - Country:US
Mailing Address - Phone:406-283-1453
Mailing Address - Fax:
Practice Address - Street 1:72 CALLAHAN CREEK RD.
Practice Address - Street 2:BUILDING A SUITE 2
Practice Address - City:TROY
Practice Address - State:MT
Practice Address - Zip Code:59935-8300
Practice Address - Country:US
Practice Address - Phone:406-777-6463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-25
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH--LCPC--64431101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional