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NPI Code Detail

MEDICARE: SUSAN E MOORE SCHNEIDER MSW, LCSW

MEDICARE: SUSAN E MOORE SCHNEIDER MSW, LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker278-123WI
2106H00000XMarriage & Family Therapist132124WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104901222
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN E MOORE SCHNEIDER MSW, LCSW
Provider Business Mailing Address
First Line : 4810 NORTHWESTERN AVE
Second Line :
City : MOUNT PLEASANT
State : WI
Zip : 53406-1504
Country : US
Telephone Number : 262-637-9984
Fax Number : 262-637-9995
Provider Business Practice Location Address
First Line : 4810 NORTHWESTERN AVE
Second Line :
City : MOUNT PLEASANT
State : WI
Zip : 53406-1504
Country : US
Telephone Number : 262-637-9984
Fax Number : 262-637-9995
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2006
Last Update Date : 08/06/2015

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