Provider Demographics
NPI:1871984260
Name:SCHROEDER, ALLISON (PHD, LCMFT)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:PHD, LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 ROCHESTER PL
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-2259
Mailing Address - Country:US
Mailing Address - Phone:410-336-4647
Mailing Address - Fax:
Practice Address - Street 1:3701 BANK ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224
Practice Address - Country:US
Practice Address - Phone:410-336-4647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-06
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCM692106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist