Provider Demographics
NPI:1144729302
Name:SCHADE, ERIC
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:SCHADE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8531 SALT GRASS DR W
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32526-3260
Mailing Address - Country:US
Mailing Address - Phone:850-361-8179
Mailing Address - Fax:
Practice Address - Street 1:1010 N 12TH AVE UNIT 327
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-3370
Practice Address - Country:US
Practice Address - Phone:850-361-8179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-02
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW150111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical