MEDICARE: HAVEN SCHULTZE SLP-CCC

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	235Z00000X	Speech-Language Pathologist	LICC-4114	MN

General Provider Information

NPI Number	:	1518837756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAVEN SCHULTZE SLP-CCC

Provider Business Mailing Address
First Line	:	1130 NICOLLET MALL
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55403-2405
Country	:	US
Telephone Number	:	402-518-8396
Fax Number	:	402-518-8396

Provider Business Practice Location Address
First Line	:	1130 NICOLLET MALL
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55403-2405
Country	:	US
Telephone Number	:	952-939-0396
Fax Number	:	402-518-8396

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

Provider Enumeration Date	:	11/11/2025
Last Update Date	:	11/11/2025

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Directions to “ HAVEN SCHULTZE SLP-CCC” Practice Location

Language	Start Address	Practice Location

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