Provider Demographics
NPI:1376987495
Name:SCHULZ, LAURA LYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LYNN
Last Name:SCHULZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 N MAYFAIR RD
Mailing Address - Street 2:STE 101
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3431
Mailing Address - Country:US
Mailing Address - Phone:414-453-8380
Mailing Address - Fax:414-443-1635
Practice Address - Street 1:500 ELM GROVE RD
Practice Address - Street 2:STE 325
Practice Address - City:ELM GROVE
Practice Address - State:WI
Practice Address - Zip Code:53122-2561
Practice Address - Country:US
Practice Address - Phone:414-453-8380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-19
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI287-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical