Provider Demographics
NPI:1063698074
Name:ZSCHAU, JACQUELINE MARY (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:MARY
Last Name:ZSCHAU
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 ANDREW CIR
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING
Mailing Address - State:KY
Mailing Address - Zip Code:41076-1888
Mailing Address - Country:US
Mailing Address - Phone:859-442-5756
Mailing Address - Fax:859-442-5269
Practice Address - Street 1:26 ANDREW CIR
Practice Address - Street 2:
Practice Address - City:COLD SPRING
Practice Address - State:KY
Practice Address - Zip Code:41076-1888
Practice Address - Country:US
Practice Address - Phone:859-442-5756
Practice Address - Fax:859-442-5269
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-21
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY19381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical