Provider Demographics
NPI:1306859764
Name:MCGRAW-SCHUCHMAN, DAVID (LICSW)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:MCGRAW-SCHUCHMAN
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:I
Other - Last Name:SCHUCHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:5905 GOLDEN VALLEY RD STE 100
Mailing Address - Street 2:VOLUNTEERS OF AMERICA MINNESOTA, MENTAL HEALTH CLINICS
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4455
Mailing Address - Country:US
Mailing Address - Phone:763-225-4052
Mailing Address - Fax:763-225-4081
Practice Address - Street 1:5905 GOLDEN VALLEY RD STE 100
Practice Address - Street 2:VOLUNTEERS OF AMERICA MINNESOTA, MENTAL HEALTH CLINICS
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55422-4455
Practice Address - Country:US
Practice Address - Phone:763-225-4052
Practice Address - Fax:763-225-4081
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN001721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN800000966Medicare ID - Type Unspecified