Healthcare Provider Details

I. General information

NPI: 1841127214
Provider Name (Legal Business Name): HALEY SHULTZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HALEY BALTZ

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 KNELLS RIDGE BLVD
CHESAPEAKE VA
23320-6607
US

IV. Provider business mailing address

1601 BIG SPRINGS PL
VIRGINIA BEACH VA
23453-4732
US

V. Phone/Fax

Practice location:
  • Phone: 757-722-9961
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810009360
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: