Provider Demographics
NPI:1336761766
Name:ANITA SCHMIDT COUNSELING, INC.
Entity Type:Organization
Organization Name:ANITA SCHMIDT COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:847-786-5682
Mailing Address - Street 1:825 S WAUKEGAN ROAD
Mailing Address - Street 2:SUITE A8 PMB 1079
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-6004
Mailing Address - Country:US
Mailing Address - Phone:847-786-5682
Mailing Address - Fax:
Practice Address - Street 1:825 S WAUKEGAN ROAD
Practice Address - Street 2:SUITE A8 PMB 1079
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-6004
Practice Address - Country:US
Practice Address - Phone:847-786-5682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-07
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF300420002Medicaid