Healthcare Provider Details

I. General information

NPI: 1467163428
Provider Name (Legal Business Name): SPENCER STEVEN SCHULTZ LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2022
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 COURT ST
UTICA NY
13502-4236
US

IV. Provider business mailing address

502 COURT ST
UTICA NY
13502-4236
US

V. Phone/Fax

Practice location:
  • Phone: 315-525-4891
  • Fax:
Mailing address:
  • Phone: 315-731-0665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number099576-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: