Provider Demographics
NPI:1962256149
Name:SCHRADER PSYCHOLOGY, LLC
Entity type:Organization
Organization Name:SCHRADER PSYCHOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHRADER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, NCSP, LP
Authorized Official - Phone:720-771-2397
Mailing Address - Street 1:11488 JAMAICA ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80640-7684
Mailing Address - Country:US
Mailing Address - Phone:720-771-2397
Mailing Address - Fax:
Practice Address - Street 1:11488 JAMAICA ST
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80640-7684
Practice Address - Country:US
Practice Address - Phone:720-771-2397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty