Provider Demographics
NPI:1962485003
Name:SCHILLER, MARIE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:
Last Name:SCHILLER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 LYNNHAVEN PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7411
Mailing Address - Country:US
Mailing Address - Phone:757-635-5008
Mailing Address - Fax:757-277-0291
Practice Address - Street 1:309 LYNNHAVEN PKWY STE 100
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7411
Practice Address - Country:US
Practice Address - Phone:757-635-5008
Practice Address - Fax:757-277-0291
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0717001054106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010142733Medicaid