Provider Demographics
NPI:1740405158
Name:SCHAUMBURG, LORRAINE A (MSW)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:A
Last Name:SCHAUMBURG
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2482 SE AVALON RD
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-6507
Mailing Address - Country:US
Mailing Address - Phone:772-335-9053
Mailing Address - Fax:
Practice Address - Street 1:4001 NE SAVANNAH RD
Practice Address - Street 2:
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-3805
Practice Address - Country:US
Practice Address - Phone:772-334-0702
Practice Address - Fax:772-334-0702
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health