Provider Demographics
NPI:1083048540
Name:SCHUCKMAN, DOTTY ANN (LSCSW)
Entity Type:Individual
Prefix:
First Name:DOTTY
Middle Name:ANN
Last Name:SCHUCKMAN
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 KANSAS AVE
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:KS
Mailing Address - Zip Code:66401-9501
Mailing Address - Country:US
Mailing Address - Phone:785-765-3850
Mailing Address - Fax:
Practice Address - Street 1:303 KANSAS AVE
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:KS
Practice Address - Zip Code:66401-9501
Practice Address - Country:US
Practice Address - Phone:785-765-3850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-02
Last Update Date:2013-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical