1124190244 NPI number — MRS. MAUREEN KAY SCHULTZ LMHP LCSW

Table of content: BAILEY LONG SLP (NPI 1669115044)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124190244 NPI number — MRS. MAUREEN KAY SCHULTZ LMHP LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHULTZ
Provider First Name:
MAUREEN
Provider Middle Name:
KAY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMHP LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCHULTZ
Provider Other First Name:
MAUREEN
Provider Other Middle Name:
KAY
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMHP LCSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1124190244
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/13/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2220 WHITLOW AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AUBURN
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68305
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-274-4534
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
820 CENTRAL AVENUE, SUITE 4
Provider Second Line Business Practice Location Address:
BLUE VALLEY BEHAVIORAL HEALTH
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-274-4373
Provider Business Practice Location Address Fax Number:
402-274-5442
Provider Enumeration Date:
11/14/2006

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: 101YM0800X , with the licence number:  652 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 581 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X , with the licence number: 457 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 470528515-00 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470528515-05 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470528515-10 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470528515-15 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 82120 . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10025207700 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470528515-06 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470528515-08 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470528515-09 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470528515-14 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8348 . This is a "MIDLANDS CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 470528515-02 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470528515-04 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470528515-07 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470528515-17 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470528515-01 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470528515-03 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470528515-13 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".