Provider Demographics
NPI:1912639972
Name:SCHALLER, KATIE LOUISE (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:LOUISE
Last Name:SCHALLER
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:LOUISE
Other - Last Name:LANDHERR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LMHC
Mailing Address - Street 1:5450 CAMEO DR
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47711-8303
Mailing Address - Country:US
Mailing Address - Phone:262-366-8748
Mailing Address - Fax:
Practice Address - Street 1:4150 ILLINOIS RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-1208
Practice Address - Country:US
Practice Address - Phone:260-745-3322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39003887A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health