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NPI Code Detail

MEDICARE: MITCHELL CHARLES SCHUTTE MA, LADC

MEDICARE: MITCHELL CHARLES SCHUTTE MA, LADC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor307241MN

General Provider Information

NPI Number : 1295693745
Entity Type Code : Individual
Provider Name (Legal Business Name) : MITCHELL CHARLES SCHUTTE MA, LADC
Provider Business Mailing Address
First Line : 10900 89TH AVE N STE 2
Second Line :
City : MAPLE GROVE
State : MN
Zip : 55369-4098
Country : US
Telephone Number : 763-200-1071
Fax Number :
Provider Business Practice Location Address
First Line : 10900 89TH AVE N STE 2
Second Line :
City : MAPLE GROVE
State : MN
Zip : 55369-4098
Country : US
Telephone Number : 763-200-1071
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2026
Last Update Date : 01/13/2026

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