Healthcare Provider Details

I. General information

NPI: 1336703370
Provider Name (Legal Business Name): MIKE SCHUETTER LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2019
Last Update Date: 12/28/2023
Certification Date: 12/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 UNIVERSITY HILLS BLVD
DALLAS TX
75241-1219
US

IV. Provider business mailing address

2601 W MARQUETTE RD
CHICAGO IL
60629-1817
US

V. Phone/Fax

Practice location:
  • Phone: 214-941-3500
  • Fax: 214-389-1084
Mailing address:
  • Phone: 773-349-8046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number178.014227
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number178.014227
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: