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General NPI Number Information
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NPI Number | 1558691279
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Entity Type | Individual
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Provider Name | MONTY SHULTZ LCSW
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Gender | Male
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Dates
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Enumeration Date | 12/31/2009
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 141 S MCCORMICK ST STE 100
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City | PRESCOTT
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State | AZ
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Zip | 86303-4730
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Country | US
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Telephone | 308-627-4743
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Fax | 928-852-0804
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Provider Business Mailing Address
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Address Line | 2960 SPRUCE MOUNTAIN RD
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City | PRESCOTT
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State | AZ
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Zip | 86303-8104
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Country | US
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Telephone | 308-627-6119
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Fax | 928-852-0804
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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 | 1219
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License Number State | NE
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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 | 9058
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 21334
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License Number State | AZ
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