Provider Demographics
NPI:1033562434
Name:HAGMEYER, KATY M (LCSW)
Entity Type:Individual
Prefix:
First Name:KATY
Middle Name:M
Last Name:HAGMEYER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATY
Other - Middle Name:MARIE
Other - Last Name:SCHMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:10361 S SHEPARD AVE
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-6499
Mailing Address - Country:US
Mailing Address - Phone:414-312-4736
Mailing Address - Fax:
Practice Address - Street 1:10361 S SHEPARD AVE
Practice Address - Street 2:
Practice Address - City:OAK CREEK
Practice Address - State:WI
Practice Address - Zip Code:53154-6499
Practice Address - Country:US
Practice Address - Phone:414-376-6309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-20
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI130288-121104100000X
WI9597-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker