Individual
MR. CLAUD RANDALL SCHROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
1317 15TH ST SE, DEMOTTE, IN 46310-9393
(219) 477-5646
(219) 728-4765
Mailing address
2004 VALPARAISO ST, VALPARAISO, IN 46383-3138
(219) 477-5646
(219) 728-4765
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39000671A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11419574
CAQH CREDENTIALING
—
05
—
300060332
—
IN
Enumeration date
12/26/2006
Last updated
10/25/2024
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