Provider Demographics
NPI:1477706901
Name:SCHAUT, LEAH BETH (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:LEAH
Middle Name:BETH
Last Name:SCHAUT
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:BETH
Other - Last Name:GOULD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:02/22/1960
Mailing Address - Street 1:3101 104TH ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANT PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53158-4419
Mailing Address - Country:US
Mailing Address - Phone:847-361-2727
Mailing Address - Fax:
Practice Address - Street 1:735 SAINT JOHNS AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-4649
Practice Address - Country:US
Practice Address - Phone:847-361-2727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7467-1231041C0700X
IL1490052621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical