1114024460 NPI number — MS. KAREN J SCHULTE MSW

Table of content: MS. KAREN J SCHULTE MSW (NPI 1114024460)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114024460 NPI number — MS. KAREN J SCHULTE MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHULTE
Provider First Name:
KAREN
Provider Middle Name:
J
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114024460
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/28/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1639 E BIG BEAVER RD
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
TROY
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48083-2053
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-528-9000
Provider Business Mailing Address Fax Number:
248-528-9005

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1639 E BIG BEAVER RD
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
TROY
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48083-2053
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-528-9000
Provider Business Practice Location Address Fax Number:
248-528-9005
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  6801007457 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 14093 . This is a "PRIORITY HEALTH/PREFERRED" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 11659486 . This is a "CAQH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 157655000 . This is a "MAGELLAN FACILITY" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 8008985630 . This is a "BCBS INDIVIDUAL FOR NEW FACILITY" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 4229896 . This is a "AETNA" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 017226000 . This is a "MAGELLAN INDIVIDUAL" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 040446 . This is a "VALUE OPTIONS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0890161 . This is a "BLUE CROSS BLUE SHIELD IN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 69824530 . This is a "UNITED BEHAVIORAL HEALTH/" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 7509107070 . This is a "BLUE CROSS BLUE SHIELD FA" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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