Provider Demographics
NPI:1902584907
Name:SCHROEDER, KARLIE ROSE (PLMHP)
Entity type:Individual
Prefix:
First Name:KARLIE
Middle Name:ROSE
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6415 S. I62 TERRACE CIR.
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135
Mailing Address - Country:US
Mailing Address - Phone:909-492-3399
Mailing Address - Fax:
Practice Address - Street 1:10840 OLD MILL RD STE 300
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-2664
Practice Address - Country:US
Practice Address - Phone:402-804-3790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13421101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor