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General NPI Number Information
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NPI Number | 1205539384
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Entity Type | Individual
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Provider Name | AMANDA SCHULTZ LPC-A
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Gender | Female
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Dates
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Enumeration Date | 03/27/2023
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Last Update Date | 03/27/2023
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Provider Practice Location Address
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Address Line | 2521 86TH ST
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City | LUBBOCK
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State | TX
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Zip | 79423-3387
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Country | US
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Telephone | 806-292-6613
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Fax |
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Provider Business Mailing Address
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Address Line | 3619 120TH ST
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City | LUBBOCK
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State | TX
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Zip | 79423-2603
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Country | US
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Telephone | 806-292-6613
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 90915
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 90915
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License Number State | TX
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