Provider Demographics
NPI:1013398254
Name:SCHOENECK, GREG J (LPC)
Entity Type:Individual
Prefix:MR
First Name:GREG
Middle Name:J
Last Name:SCHOENECK
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:MR
Other - First Name:GREGORY
Other - Middle Name:J
Other - Last Name:SCHOENECK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:2625 S GREELEY ST
Mailing Address - Street 2:BOX #9
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207
Mailing Address - Country:US
Mailing Address - Phone:414-644-0006
Mailing Address - Fax:
Practice Address - Street 1:2625 S GREELEY ST
Practice Address - Street 2:BOX #9
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53207
Practice Address - Country:US
Practice Address - Phone:414-644-0006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-13
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6230 - 125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100046903Medicaid