Healthcare Provider Details

I. General information

NPI: 1467904706
Provider Name (Legal Business Name): CHRISTY MARIE SCHICK LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2016
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3820 LONDON RD APT 213
DULUTH MN
55804-2239
US

IV. Provider business mailing address

3820 LONDON RD APT 213
DULUTH MN
55804-2239
US

V. Phone/Fax

Practice location:
  • Phone: 612-465-9025
  • Fax:
Mailing address:
  • Phone: 218-250-6169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number19524
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number19524
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: