Provider Demographics
NPI:1932063955
Name:SCHULTE, RAEGAN LYNN
Entity type:Individual
Prefix:
First Name:RAEGAN
Middle Name:LYNN
Last Name:SCHULTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14604 165TH ST
Mailing Address - Street 2:
Mailing Address - City:SPERRY
Mailing Address - State:IA
Mailing Address - Zip Code:52650-9603
Mailing Address - Country:US
Mailing Address - Phone:319-208-9648
Mailing Address - Fax:
Practice Address - Street 1:409 N 4TH ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52601-5255
Practice Address - Country:US
Practice Address - Phone:319-208-9648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-13
Last Update Date:2025-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA127767101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty