Provider Demographics
NPI:1407742737
Name:PAUL SCHELLENBERG, LLC
Entity type:Organization
Organization Name:PAUL SCHELLENBERG, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHELLENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:309-696-0267
Mailing Address - Street 1:3526 N CALIFORNIA AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61603-1164
Mailing Address - Country:US
Mailing Address - Phone:309-696-0267
Mailing Address - Fax:
Practice Address - Street 1:3526 N CALIFORNIA AVE STE 206
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61603-1164
Practice Address - Country:US
Practice Address - Phone:309-696-0267
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty