Provider Demographics
NPI:1275723504
Name:MCAULIFFE-SCHROEDER, WILLIAM R (LCSW, SAC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:R
Last Name:MCAULIFFE-SCHROEDER
Suffix:
Gender:M
Credentials:LCSW, SAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 FEMRITE DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:MONONA
Mailing Address - State:WI
Mailing Address - Zip Code:53716-3787
Mailing Address - Country:US
Mailing Address - Phone:608-223-3342
Mailing Address - Fax:
Practice Address - Street 1:1250 FEMRITE DR
Practice Address - Street 2:SUITE 205
Practice Address - City:MONONA
Practice Address - State:WI
Practice Address - Zip Code:53716-3787
Practice Address - Country:US
Practice Address - Phone:608-223-3342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12640-131101YA0400X
WI3629-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39571400Medicaid
WI12640-131OtherSUBSTANCE ABUSE COUNSELOR
WI3629-123OtherLCSW CREDENTIAL #