Provider Demographics
NPI:1447017272
Name:SCHOENWETTER, STACY LEE (MS, LMHC)
Entity type:Individual
Prefix:MRS
First Name:STACY
Middle Name:LEE
Last Name:SCHOENWETTER
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:LEE
Other - Last Name:GOLDMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3112 17TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-6021
Mailing Address - Country:US
Mailing Address - Phone:407-957-4176
Mailing Address - Fax:
Practice Address - Street 1:3112 17TH ST
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-6021
Practice Address - Country:US
Practice Address - Phone:407-957-4176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23401101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health