Provider Demographics
NPI:1154771830
Name:SCHMAUS, SHANNON (LMSW)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:SCHMAUS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25176 FORTUNA ST
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-3797
Mailing Address - Country:US
Mailing Address - Phone:586-838-0882
Mailing Address - Fax:
Practice Address - Street 1:1750 S TELEGRAPH RD STE 101
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0177
Practice Address - Country:US
Practice Address - Phone:586-838-0882
Practice Address - Fax:248-451-9089
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-14
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010994001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical