Provider Demographics
NPI:1114548385
Name:SCHLUTER, MARIE AGATHA (LMSW, EDS)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:AGATHA
Last Name:SCHLUTER
Suffix:
Gender:F
Credentials:LMSW, EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24773 REEDS POINTE DR
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-2537
Mailing Address - Country:US
Mailing Address - Phone:248-921-4614
Mailing Address - Fax:
Practice Address - Street 1:24773 REEDS POINTE DR
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374-2537
Practice Address - Country:US
Practice Address - Phone:248-921-4614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010625021041C0700X, 1041S0200X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool