Provider Demographics
NPI:1073535472
Name:SCHUMACHER, TINA M (LCSW, CSAC, ICS)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:M
Last Name:SCHUMACHER
Suffix:
Gender:F
Credentials:LCSW, CSAC, ICS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7010 S CRANE DR
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-1666
Mailing Address - Country:US
Mailing Address - Phone:414-530-6726
Mailing Address - Fax:
Practice Address - Street 1:7010 S CRANE DR
Practice Address - Street 2:
Practice Address - City:OAK CREEK
Practice Address - State:WI
Practice Address - Zip Code:53154-1666
Practice Address - Country:US
Practice Address - Phone:414-530-6726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7438-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40952900Medicaid