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NPI Code Detail

MEDICARE: JEAN M SCHULT LCSW

MEDICARE: JEAN M SCHULT LCSW
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
11041C0700XClinical Social Worker074072NY

General Provider Information

NPI Number : 1982756938
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEAN M SCHULT LCSW
Provider Business Mailing Address
First Line : 265 TERRY BLVD
Second Line :
City : HOLBROOK
State : NY
Zip : 11741-3324
Country : US
Telephone Number : 631-665-6707
Fax Number :
Provider Business Practice Location Address
First Line : 21 4TH AVE
Second Line :
City : BAY SHORE
State : NY
Zip : 11706-7908
Country : US
Telephone Number : 631-665-6707
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2007
Last Update Date : 05/20/2025

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