Provider Demographics
NPI:1871043984
Name:SUZANNE ROUNDY-SCHMIDT, LLC
Entity Type:Organization
Organization Name:SUZANNE ROUNDY-SCHMIDT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PRACTIONER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROUNDY-SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:414-418-2835
Mailing Address - Street 1:740 S 103RD ST
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53214-2526
Mailing Address - Country:US
Mailing Address - Phone:414-418-2835
Mailing Address - Fax:
Practice Address - Street 1:400 GENESEE ST
Practice Address - Street 2:3RD FLOOR SUITE B
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018-1867
Practice Address - Country:US
Practice Address - Phone:414-418-2835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-12
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI77061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty