Healthcare Provider Details

I. General information

NPI: 1053655696
Provider Name (Legal Business Name): JOSEY RENEE SCHOUWEILER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2012
Last Update Date: 08/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 WASHINGTON SQ
WASHINGTON IL
61571-2657
US

IV. Provider business mailing address

128 WASHINGTON SQ
WASHINGTON IL
61571-2657
US

V. Phone/Fax

Practice location:
  • Phone: 309-481-5177
  • Fax: 800-773-1682
Mailing address:
  • Phone: 309-481-5177
  • Fax: 800-773-1682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.016914
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: