Healthcare Provider Details

I. General information

NPI: 1497891212
Provider Name (Legal Business Name): ROBIN R SCHULTZ LMHC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 02/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 CARL VINSON PKWY
WARNER ROBINS GA
31088-5817
US

IV. Provider business mailing address

121 CARL VINSON PKWY
WARNER ROBINS GA
31088-5817
US

V. Phone/Fax

Practice location:
  • Phone: 478-922-2365
  • Fax: 478-922-1778
Mailing address:
  • Phone: 478-922-2365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH8520
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC005259
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: