Provider Demographics
NPI:1730651944
Name:BUETTNER, EMILY NIKOLAUS (LMFT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:NIKOLAUS
Last Name:BUETTNER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:MARIE
Other - Last Name:NIKOLAUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:915 N RACINE AVE APT 2SE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-0008
Mailing Address - Country:US
Mailing Address - Phone:262-408-0645
Mailing Address - Fax:
Practice Address - Street 1:155 N MICHIGAN AVE STE 202
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7940
Practice Address - Country:US
Practice Address - Phone:312-278-3054
Practice Address - Fax:312-722-6938
Is Sole Proprietor?:No
Enumeration Date:2018-12-28
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166001246106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist