Provider Demographics
NPI:1457756744
Name:SCHLEGEL, COURTNEY M (LCSW)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:M
Last Name:SCHLEGEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:M
Other - Last Name:PUTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:903 MINERAL POINT AVE
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53548-2970
Mailing Address - Country:US
Mailing Address - Phone:608-756-6530
Mailing Address - Fax:608-741-6918
Practice Address - Street 1:903 MINERAL POINT AVE
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53548-2970
Practice Address - Country:US
Practice Address - Phone:608-756-6530
Practice Address - Fax:608-741-6918
Is Sole Proprietor?:No
Enumeration Date:2014-10-29
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI128880-121104100000X
WI8294-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1457756744OtherDEANHEALTH PLAN
WI1457756744Medicaid
WI1457756744OtherBCBSWI
WISCHLECOUOtherMERCYCARE INSURANCE
WI1457756744Medicaid