Provider Demographics
NPI:1518263276
Name:SCHEPKE, PHYLLIS LYNNE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:PHYLLIS
Middle Name:LYNNE
Last Name:SCHEPKE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 W WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-2929
Mailing Address - Country:US
Mailing Address - Phone:989-358-0673
Mailing Address - Fax:
Practice Address - Street 1:346 LONG RAPIDS PLZ
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-1374
Practice Address - Country:US
Practice Address - Phone:989-358-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-28
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010896311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIZ16001089Medicare PIN