Provider Demographics
NPI:1720522808
Name:STROHEKER, MICHELLE LUCILLE (LCPC, CADC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LUCILLE
Last Name:STROHEKER
Suffix:
Gender:F
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:LUCILLE
Other - Last Name:SKOTZKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC, CADC
Mailing Address - Street 1:109 E MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:GILLESPIE
Mailing Address - State:IL
Mailing Address - Zip Code:62033-1473
Mailing Address - Country:US
Mailing Address - Phone:217-839-1526
Mailing Address - Fax:217-839-1538
Practice Address - Street 1:109 E MAPLE ST
Practice Address - Street 2:
Practice Address - City:GILLESPIE
Practice Address - State:IL
Practice Address - Zip Code:62033-1473
Practice Address - Country:US
Practice Address - Phone:217-839-1526
Practice Address - Fax:217-839-1538
Is Sole Proprietor?:No
Enumeration Date:2016-12-08
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180010160101YA0400X, 101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL376001351007Medicaid