Provider Demographics
NPI:1306438411
Name:SCHNEIDER, MAXWELL (MHC-LP)
Entity type:Individual
Prefix:
First Name:MAXWELL
Middle Name:
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 IRVING AVE APT 1R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-4491
Mailing Address - Country:US
Mailing Address - Phone:440-665-5523
Mailing Address - Fax:
Practice Address - Street 1:120 W 31ST ST FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3407
Practice Address - Country:US
Practice Address - Phone:917-476-4397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP108389101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP108389OtherLIMITED PERMIT TO PRACTICE MENTAL HEALTH COUNSELING