Healthcare Provider Details

I. General information

NPI: 1437138518
Provider Name (Legal Business Name): JUDY L SCHULTZ LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 LAFAYETTE ST
SCHENECTADY NY
12305-2408
US

IV. Provider business mailing address

1336 LEXINGTON AVE
SCHENECTADY NY
12309-5608
US

V. Phone/Fax

Practice location:
  • Phone: 518-243-3300
  • Fax: 518-377-9151
Mailing address:
  • Phone: 518-346-5250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number000065
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: