Provider Demographics
NPI:1972671865
Name:SCHLUCKBIER, DANIEL JOHN (LLPC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:JOHN
Last Name:SCHLUCKBIER
Suffix:
Gender:M
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58755 VIRGINA CIRCLE
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:48048
Mailing Address - Country:US
Mailing Address - Phone:586-419-3356
Mailing Address - Fax:
Practice Address - Street 1:15945 CANAL
Practice Address - Street 2:CATHOLIC SERVICES OF MACOMB
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038
Practice Address - Country:US
Practice Address - Phone:586-416-2300
Practice Address - Fax:586-416-2311
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401010179101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
0M87020Medicare ID - Type Unspecified