Healthcare Provider Details

I. General information

NPI: 1518810233
Provider Name (Legal Business Name): JOSEPH ROBERT SCHANTZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2026
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 W 34TH ST
MINNEAPOLIS MN
55408-4348
US

IV. Provider business mailing address

3003 E 29TH ST
MINNEAPOLIS MN
55406-1602
US

V. Phone/Fax

Practice location:
  • Phone: 612-668-4000
  • Fax:
Mailing address:
  • Phone: 612-668-0254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number1027347
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: