Healthcare Provider Details

I. General information

NPI: 1568398428
Provider Name (Legal Business Name): LISA MARIE SCHROEDER LCSW, CTTP-1
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 E NORRIS DR
OTTAWA IL
61350-1604
US

IV. Provider business mailing address

920 WEST ST STE 118
PERU IL
61354-2765
US

V. Phone/Fax

Practice location:
  • Phone: 815-431-5735
  • Fax:
Mailing address:
  • Phone: 815-434-4382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.031535
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: