Provider Demographics
NPI:1487793345
Name:GAUGER, LYNN JOY (MSSW)
Entity type:Individual
Prefix:MS
First Name:LYNN
Middle Name:JOY
Last Name:GAUGER
Suffix:
Gender:F
Credentials:MSSW
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:JOY
Other - Last Name:SCHEUERMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSSW
Mailing Address - Street 1:1524 N FARWELL AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-2329
Mailing Address - Country:US
Mailing Address - Phone:414-273-2220
Mailing Address - Fax:414-273-2223
Practice Address - Street 1:740 NORTH PILGRIM PARKWAY
Practice Address - Street 2:SUITE 206
Practice Address - City:ELM GROVE
Practice Address - State:WI
Practice Address - Zip Code:53122
Practice Address - Country:US
Practice Address - Phone:414-273-2220
Practice Address - Fax:414-273-2223
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI768-1231041C0700X
WI27-124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI395649000Medicaid
WI395649000Medicaid