Provider Demographics
NPI:1780778985
Name:SCHROEDER, ANTHONY J (LCSW)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:J
Last Name:SCHROEDER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:ANTHONY
Other - Middle Name:J
Other - Last Name:SCHROEDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:606 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:IN
Mailing Address - Zip Code:47250-4708
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:606 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:IN
Practice Address - Zip Code:47250-4708
Practice Address - Country:US
Practice Address - Phone:812-265-4151
Practice Address - Fax:812-265-5028
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34000171A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical