=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245022508
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CATHLEEN ANN SCHULTZ MS, NCC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/21/2025
-----------------------------------------------------
Last Update Date | 05/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 480 PIERCE ST STE 108
-----------------------------------------------------
City | KINGSTON
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18704-5512
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-855-8787
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 582 MCKINLEY ST
-----------------------------------------------------
City | BANGOR
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18013-1336
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-230-7778
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------