Provider Demographics
NPI:1487710992
Name:SCHNEIDER, CAROL JOYCE (PHD)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:JOYCE
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 KALMIA AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-1810
Mailing Address - Country:US
Mailing Address - Phone:303-449-2364
Mailing Address - Fax:303-449-6965
Practice Address - Street 1:1229 KALMIA AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-1810
Practice Address - Country:US
Practice Address - Phone:303-449-2364
Practice Address - Fax:303-449-6965
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO322103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC15624Medicare PIN