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General NPI Number Information
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NPI Number | 1568900397
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Entity Type | Organization
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Legal Business Name | SCHULTZ FAMILY COUNSELING, LLC.
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Dates
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Enumeration Date | 01/31/2017
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Last Update Date | 01/31/2017
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Provider Practice Location Address
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Address Line | 1651 LUDINGTON ST
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City | MARINETTE
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State | WI
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Zip | 54143-1812
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Country | US
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Telephone | 906-271-0406
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Fax |
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Provider Business Mailing Address
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Address Line | 908 2ND ST
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City | MENOMINEE
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State | MI
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Zip | 49858-3245
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Country | US
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Telephone | 906-864-9830
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Fax |
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Authorized Official
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Title or Position | LPC-IT/ADMINISTRATOR
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Name | STEPHANIE SPADE SCHULTZ
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Credential | MA
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Telephone | 906-864-9830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 3164
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License Number State | WI
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