Provider Demographics
NPI:1912123563
Name:SCHNEIDER, SHERRI KAY (LICSW)
Entity type:Individual
Prefix:MS
First Name:SHERRI
Middle Name:KAY
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 BRYANT AVE S APT 206
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55405-2832
Mailing Address - Country:US
Mailing Address - Phone:612-870-1382
Mailing Address - Fax:651-645-3216
Practice Address - Street 1:1593 HEWITT AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-1221
Practice Address - Country:US
Practice Address - Phone:651-645-9424
Practice Address - Fax:651-645-3216
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN104481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN347112800OtherPROVIDER NUMBER