Provider Demographics
NPI:1568090462
Name:SCHUSTER, PAUL SAMUEL
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:SAMUEL
Last Name:SCHUSTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3249 HENNEPIN AVE STE 258
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-3993
Mailing Address - Country:US
Mailing Address - Phone:612-900-3962
Mailing Address - Fax:
Practice Address - Street 1:3249 HENNEPIN AVE STE 258
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-3993
Practice Address - Country:US
Practice Address - Phone:612-900-3962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-28
Last Update Date:2020-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN274681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical