Provider Demographics
NPI:1922143866
Name:SCHNEIDER, REVA JANE (LCPC)
Entity Type:Individual
Prefix:
First Name:REVA
Middle Name:JANE
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9239 KOSTNER AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1623
Mailing Address - Country:US
Mailing Address - Phone:847-679-3446
Mailing Address - Fax:847-983-5446
Practice Address - Street 1:9239 KOSTNER AVE
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1623
Practice Address - Country:US
Practice Address - Phone:847-679-3446
Practice Address - Fax:847-983-5446
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health