1124190244 NPI number — MRS. MAUREEN KAY SCHULTZ LMHP LCSW

Table of content: MRS. MAUREEN KAY SCHULTZ LMHP LCSW (NPI 1124190244)

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".




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