Provider Demographics
NPI:1366622292
Name:SCHLUTTER & ASSOCIATES LLC
Entity type:Organization
Organization Name:SCHLUTTER & ASSOCIATES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LOIS
Authorized Official - Middle Name:COCHRANE
Authorized Official - Last Name:SCHLUTTER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:952-925-5344
Mailing Address - Street 1:6200 EXCELSIOR BLVD
Mailing Address - Street 2:#202
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-2730
Mailing Address - Country:US
Mailing Address - Phone:952-548-9340
Mailing Address - Fax:952-548-9350
Practice Address - Street 1:6200 EXCELSIOR BLVD
Practice Address - Street 2:#202
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-2730
Practice Address - Country:US
Practice Address - Phone:952-548-9340
Practice Address - Fax:952-548-9350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP 1900103TA0400X
MNLP1900103TF0200X, 103TH0004X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensicGroup - Multi-Specialty
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNC03610Medicare PIN