Provider Demographics
NPI:1447325618
Name:SCHLONEGER, KEVIN JAY (PHD, LP)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:JAY
Last Name:SCHLONEGER
Suffix:
Gender:M
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103 RESEARCH FOREST DR STE 175
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-4162
Mailing Address - Country:US
Mailing Address - Phone:844-824-8775
Mailing Address - Fax:281-648-2200
Practice Address - Street 1:2103 RESEARCH FOREST DR STE 175
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-4162
Practice Address - Country:US
Practice Address - Phone:844-824-8775
Practice Address - Fax:281-648-2200
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30820103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX140937702Medicaid
TX00471POtherBCBS OF TEXAS
TX8F7015Medicare PIN