Healthcare Provider Details

I. General information

NPI: 1073879201
Provider Name (Legal Business Name): MICHELLE SCHRUBBE PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2012
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2320 RIVER BEND RD
PLOVER WI
54467-2726
US

IV. Provider business mailing address

S87W28208 LOOKOUT LN
MUKWONAGO WI
53149-9661
US

V. Phone/Fax

Practice location:
  • Phone: 262-366-6669
  • Fax:
Mailing address:
  • Phone: 262-366-6669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number15785-132
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5148-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: