Provider Demographics
NPI:1619524600
Name:SCHAUB, LYNN (LMSW, CCM, CBIS)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:SCHAUB
Suffix:
Gender:F
Credentials:LMSW, CCM, CBIS
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:
Other - Last Name:CONZEMIUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW, CCM, CBIS
Mailing Address - Street 1:2550 S TELEGRAPH RD STE 250
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0909
Mailing Address - Country:US
Mailing Address - Phone:248-322-0003
Mailing Address - Fax:
Practice Address - Street 1:1800 N MILFORD RD STE 100
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-1047
Practice Address - Country:US
Practice Address - Phone:248-684-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-23
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010820761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical