MEDICARE: MR. JEFFREY H SCHULZ LPC, CSAC, ICS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	4025-125	WI
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	2053-132	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235246521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JEFFREY H SCHULZ LPC, CSAC, ICS

Provider Business Mailing Address
First Line	:	690 THIRD STREET
Second Line	:
City	:	BELOIT
State	:	WI
Zip	:	53512-0898
Country	:	US
Telephone Number	:	262-898-3377
Fax Number	:

Provider Business Practice Location Address
First Line	:	2405 NORTHWESTERN AVE
Second Line	:
City	:	RACINE
State	:	WI
Zip	:	53404-2534
Country	:	US
Telephone Number	:	262-898-3377
Fax Number	:	262-898-3378

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	05/03/2013

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