Provider Demographics
NPI:1063560100
Name:SCHEUERMANN, COLETTE THERESE (MSW)
Entity type:Individual
Prefix:
First Name:COLETTE
Middle Name:THERESE
Last Name:SCHEUERMANN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8047 TAUREN CT
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-7718
Mailing Address - Country:US
Mailing Address - Phone:847-359-7917
Mailing Address - Fax:847-359-7917
Practice Address - Street 1:8047 TAUREN CT
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-7718
Practice Address - Country:US
Practice Address - Phone:847-359-7917
Practice Address - Fax:847-359-7917
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149003493101YM0800X
FLSW13074101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL$$$$$$$$$001Medicaid