Provider Demographics
NPI:1659681856
Name:SCHULSTROM, GAIL JOYCE (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:JOYCE
Last Name:SCHULSTROM
Suffix:
Gender:F
Credentials:MSW, LICSW
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Mailing Address - Street 1:12601 RIDGEDALE DRIVE RIDGEDALE SERVICE CENTER
Mailing Address - Street 2:HENNEPIN COUNTY CHILDREN'S MENTAL HEALTH CRISIS SERVICE
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305
Mailing Address - Country:US
Mailing Address - Phone:612-348-8801
Mailing Address - Fax:952-541-6270
Practice Address - Street 1:12601 RIDGEDALE DRIVE, RIDGEDALE SERVICE CENTER
Practice Address - Street 2:HENNEPIN COUNTY CHILDREN'S MENTAL HEALTH CRISIS SERVICE
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305
Practice Address - Country:US
Practice Address - Phone:612-348-8801
Practice Address - Fax:952-541-6270
Is Sole Proprietor?:No
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN#3941104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker