Provider Demographics
NPI:1336703370
Name:SCHUETTER, MIKE (LPC)
Entity Type:Individual
Prefix:
First Name:MIKE
Middle Name:
Last Name:SCHUETTER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 W MARQUETTE RD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60629-1817
Mailing Address - Country:US
Mailing Address - Phone:773-349-8046
Mailing Address - Fax:
Practice Address - Street 1:5300 UNIVERSITY HILLS BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75241-1219
Practice Address - Country:US
Practice Address - Phone:214-941-3500
Practice Address - Fax:214-389-1084
Is Sole Proprietor?:No
Enumeration Date:2019-04-25
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
IL178.014227101YM0800X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL140739484Medicaid