Provider Demographics
NPI:1033984851
Name:SCHUBERT, JEANIE JANICKI (MSW)
Entity type:Individual
Prefix:
First Name:JEANIE
Middle Name:JANICKI
Last Name:SCHUBERT
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 1:1324 NOEL CT
Mailing Address - Street 2:
Mailing Address - City:SOUTH MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53172-3575
Mailing Address - Country:US
Mailing Address - Phone:414-303-5005
Mailing Address - Fax:
Practice Address - Street 1:5900 W NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53214-3448
Practice Address - Country:US
Practice Address - Phone:414-303-5005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI89-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker