Provider Demographics
NPI:1235479551
Name:SCHNOOR, DEBRA SUE (LCSW, CSAC, MSW)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:SUE
Last Name:SCHNOOR
Suffix:
Gender:F
Credentials:LCSW, CSAC, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36500 AURORA DR
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:WI
Mailing Address - Zip Code:53066-4899
Mailing Address - Country:US
Mailing Address - Phone:414-773-4312
Mailing Address - Fax:262-434-5809
Practice Address - Street 1:1220 DEWEY AVE
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53213-2504
Practice Address - Country:US
Practice Address - Phone:414-454-6779
Practice Address - Fax:414-454-6450
Is Sole Proprietor?:No
Enumeration Date:2013-02-22
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15675-132101YA0400X
WI128174-1211041C0700X
WI8082-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1235479551Medicaid
WISCHNODEBOtherMERCYCARE INSURANCE
WI1235479551OtherBCBSWI
WI1235479551Medicaid