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General NPI Number Information
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NPI Number | 1376852616
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Entity Type | Organization
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Legal Business Name | KATHY SCHUTZ LCSW PC
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Dates
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Enumeration Date | 10/05/2010
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Last Update Date | 04/29/2011
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Provider Practice Location Address
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Address Line | 702 CROMWELL DR SUITE G
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City | GREENVILLE
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State | NC
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Zip | 27858-5436
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Country | US
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Telephone | 252-714-1755
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Fax |
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Provider Business Mailing Address
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Address Line | 3709 BARTON WAY
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City | GRIMESLAND
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State | NC
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Zip | 27837-9159
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KATHY SCHUTZ
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Credential | LCSW
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Telephone | 252-714-1755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1229
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C005392
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1806
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | C005392
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License Number State | NC
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