Provider Demographics
NPI:1144974007
Name:SCHROEDER, SHAWN JOSEPH
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:JOSEPH
Last Name:SCHROEDER
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 1:7801 YORK RD STE 360
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7465
Mailing Address - Country:US
Mailing Address - Phone:410-847-7171
Mailing Address - Fax:
Practice Address - Street 1:7801 YORK RD STE 360
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7465
Practice Address - Country:US
Practice Address - Phone:410-847-7171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-09
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional