Provider Demographics
NPI:1154467850
Name:SCHNEEBERGER, STEPHANIE J (MA, LCPC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:J
Last Name:SCHNEEBERGER
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 S STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-3433
Mailing Address - Country:US
Mailing Address - Phone:630-629-6412
Mailing Address - Fax:
Practice Address - Street 1:1919 MAIN ST
Practice Address - Street 2:
Practice Address - City:MELROSE PARK
Practice Address - State:IL
Practice Address - Zip Code:60160-3737
Practice Address - Country:US
Practice Address - Phone:708-343-1571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional