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General NPI Number Information
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NPI Number | 1922818509
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Entity Type | Individual
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Provider Name | JOHANNA SCHULTZ MA, LPCC
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Gender | Female
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 611 WALNUT ST
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City | MONTICELLO
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State | MN
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Zip | 55362-4574
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Country | US
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Telephone | 612-712-5244
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Fax |
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Provider Business Mailing Address
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Address Line | 2459 58TH ST NE
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City | BUFFALO
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State | MN
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Zip | 55313-3646
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Country | US
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Telephone | 218-849-2613
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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 | 4787
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License Number State | MN
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