Provider Demographics
NPI:1740016971
Name:SCHWEDA, CAROLYN MARIE
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:MARIE
Last Name:SCHWEDA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 E SILVER SPRING DR STE 206
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH BAY
Mailing Address - State:WI
Mailing Address - Zip Code:53217-4704
Mailing Address - Country:US
Mailing Address - Phone:414-885-0033
Mailing Address - Fax:
Practice Address - Street 1:155 E SILVER SPRING DR STE 206
Practice Address - Street 2:
Practice Address - City:WHITEFISH BAY
Practice Address - State:WI
Practice Address - Zip Code:53217-4704
Practice Address - Country:US
Practice Address - Phone:414-885-0033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-13
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI205-36221700000X
WI5433-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist