Provider Demographics
NPI:1699913913
Name:SCHNEIDER, HENRY L (PHD)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:L
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 AVALON RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-3901
Mailing Address - Country:US
Mailing Address - Phone:516-487-3005
Mailing Address - Fax:516-487-3005
Practice Address - Street 1:5 AVALON RD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-3901
Practice Address - Country:US
Practice Address - Phone:516-487-3005
Practice Address - Fax:516-487-3005
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-23
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY8049103T00000X, 103T00000X
103TC2200X, 103TP0814X, 103TP2701X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist