MEDICARE: SUZANNE SCHULTZ MS,LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor
2	101YP2500X	Professional Counselor	9787	TX

General Provider Information

NPI Number	:	1093803108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE SCHULTZ MS,LPC

Provider Business Mailing Address
First Line	:	13345 N CENTRAL EXPY
Second Line	:	SUITE 200
City	:	DALLAS
State	:	TX
Zip	:	75243-1126
Country	:	US
Telephone Number	:	972-754-6092
Fax Number	:	972-248-5567

Provider Business Practice Location Address
First Line	:	13345 N CENTRAL EXPY
Second Line	:	SUITE 200
City	:	DALLAS
State	:	TX
Zip	:	75243-1126
Country	:	US
Telephone Number	:	972-248-5567
Fax Number	:	214-503-6433

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	12/29/2022

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