Provider Demographics
NPI:1710105796
Name:SCHOONOVER, CONNIE LEANN (MS, MED, LPC, PC)
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:LEANN
Last Name:SCHOONOVER
Suffix:
Gender:F
Credentials:MS, MED, LPC, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5550 CHUKAR TRL
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-3052
Mailing Address - Country:US
Mailing Address - Phone:719-659-2502
Mailing Address - Fax:
Practice Address - Street 1:5550 CHUKAR TRL
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-3052
Practice Address - Country:US
Practice Address - Phone:719-659-2502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12440101YP2500X
CO3529101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO532842Medicaid