Healthcare Provider Details

I. General information

NPI: 1467162099
Provider Name (Legal Business Name): JACOB LEVI SCHOOLER LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2022
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1312 W 6TH ST
LAWRENCE KS
66044-2219
US

IV. Provider business mailing address

1312 W 6TH ST
LAWRENCE KS
66044-2219
US

V. Phone/Fax

Practice location:
  • Phone: 785-841-7297
  • Fax: 785-856-0375
Mailing address:
  • Phone: 785-841-7297
  • Fax: 785-856-0375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number06123
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: