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NPI 1134645237

NPI 1134645237 : JEFFREY BRANDT SCHULZ LPC, LCDC : NACOGDOCHES, TX

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General NPI Number Information
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    NPI Number           |    1134645237
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    Entity Type          |    Individual 
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    Provider Name        |    JEFFREY BRANDT SCHULZ LPC, LCDC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/21/2017
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    Last Update Date     |    07/21/2022
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Provider Practice Location Address
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    Address Line         |    412 NORTH ST STE B 
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    City                 |    NACOGDOCHES
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    State                |    TX
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    Zip                  |    75961-5070
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    Country              |    US
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    Telephone            |    936-615-0256
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    412 NORTH ST STE B 
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    City                 |    NACOGDOCHES
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    State                |    TX
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    Zip                  |    75961-5070
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    Country              |    US
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    Telephone            |    936-615-0256
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    11737
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    License Number State |    TX
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Taxonomy #2
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    69691
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    License Number State |    TX
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Taxonomy #3
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    Taxonomy Code        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    69691
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    License Number State |    TX
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