Healthcare Provider Details

I. General information

NPI: 1679495386
Provider Name (Legal Business Name): TERESA SCHROEDER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 LINCOLN PLACE CT STE 406
BELLEVILLE IL
62221-5825
US

IV. Provider business mailing address

131 LINCOLN PLACE CT STE 406
BELLEVILLE IL
62221-5825
US

V. Phone/Fax

Practice location:
  • Phone: 314-495-0585
  • Fax: 314-667-3325
Mailing address:
  • Phone: 314-495-0585
  • Fax: 314-667-3325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: TERESA SCHROEDER
Title or Position: COUNSELOR
Credential: MA LCPC
Phone: 314-495-0585