Provider Demographics
NPI:1851685143
Name:SCHMUTZER, MARY ASHLEY (MA, LPC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ASHLEY
Last Name:SCHMUTZER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25W361 DORIS AVE
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-2302
Mailing Address - Country:US
Mailing Address - Phone:630-668-2538
Mailing Address - Fax:
Practice Address - Street 1:1616 E ROOSEVELT RD
Practice Address - Street 2:SUITE 8
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-6850
Practice Address - Country:US
Practice Address - Phone:630-588-1201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-03
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178007356101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional