Provider Demographics
NPI:1588925176
Name:SCHROEDER ASSOCIATES PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:SCHROEDER ASSOCIATES PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:860-875-0292
Mailing Address - Street 1:3234 CITY LIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-2632
Mailing Address - Country:US
Mailing Address - Phone:949-800-7863
Mailing Address - Fax:
Practice Address - Street 1:60 ELM ST
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-3240
Practice Address - Country:US
Practice Address - Phone:860-875-0292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000521106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty