Organization
JAN SCHAAD LCSW PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE A SCHAAD MSW LCSW (PRESIDENT)
(307) 630-4688
Entity
Organization
Contact information
Practice address
2622 PIONEER AVE, CHEYENNE, WY 82001-3024
(307) 630-4688
(307) 637-2899
Mailing address
PO BOX 326, CHEYENNE, WY 82003-0326
(307) 763-0468
(307) 637-2899
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
410
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123007700
—
WY
01
—
P00368425
MEDICARE RAILROAD
WY
01
—
W21033
MEDICARE PROVIDER TRANSACTION NUMBER
WY
Enumeration date
05/11/2006
Last updated
04/04/2012
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