Provider Demographics
NPI:1184319352
Name:SCHADE, DONALD LEE III (LCSW)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:LEE
Last Name:SCHADE
Suffix:III
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 FORBES ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:WI
Mailing Address - Zip Code:54940-8905
Mailing Address - Country:US
Mailing Address - Phone:920-851-3271
Mailing Address - Fax:
Practice Address - Street 1:400 FORBES ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:WI
Practice Address - Zip Code:54940-8905
Practice Address - Country:US
Practice Address - Phone:920-851-3271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI111581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical