Individual provider Active NPI

Mary Diana Schroer, MS, LCPC

  • Mental Health Counselor
  • Peoria, IL
National Provider Identifier
1073663712
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
4307 N Sterling Ave
Peoria, IL 61615-3837
Phone
(309) 678-8817
NPI assigned
Jan 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary
Professional Counselor 101YP2500X IL

Addresses

Primary practice location

4307 N Sterling Ave
Peoria, IL 61615-3837

Mailing address

2405 N Linn St
Peoria, IL 61604-3627
Phone (309) 685-8817

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
180005065ILMDProfessional Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1073663712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 N LINN ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616043627",
            "telephone_number": "309-685-8817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4307 N STERLING AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616153837",
            "telephone_number": "309-678-8817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROER",
        "first_name": "MARY",
        "middle_name": "DIANA",
        "name_prefix": "Ms.",
        "credential": "MS, LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.