Provider Demographics
NPI:1063112589
Name:SCHMIDT, BROOKE (LMFT)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2602 W 104TH PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60655-1607
Mailing Address - Country:US
Mailing Address - Phone:773-597-8516
Mailing Address - Fax:
Practice Address - Street 1:8 S MICHIGAN AVE STE 1420
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-3365
Practice Address - Country:US
Practice Address - Phone:708-872-7443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist