Provider Demographics
NPI:1730500455
Name:SCHNEIDER, KATIE KELLEY (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:KELLEY
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:SCHNEIDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1200 N ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-2259
Mailing Address - Country:US
Mailing Address - Phone:773-850-2295
Mailing Address - Fax:
Practice Address - Street 1:1200 N ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-2259
Practice Address - Country:US
Practice Address - Phone:773-850-2295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-23
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.009610101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional