Provider Demographics
NPI:1790737435
Name:HOLSCHUH, MARILYN C (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:C
Last Name:HOLSCHUH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6510 GRAND TETON PLZ
Mailing Address - Street 2:SUITE 406
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-1029
Mailing Address - Country:US
Mailing Address - Phone:608-833-9290
Mailing Address - Fax:608-833-9691
Practice Address - Street 1:437 S YELLOWSTONE DR STE 106
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1096
Practice Address - Country:US
Practice Address - Phone:608-268-0341
Practice Address - Fax:608-268-0342
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI523-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI10536OtherDEAN HEALTH PLAN
WI42252500Medicaid
WI39517700Medicaid