1972180396 NPI number — KAREN A SCHULZ MP PSYCHOLOGIST PC

Table of content: (NPI 1972180396)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972180396 NPI number — KAREN A SCHULZ MP PSYCHOLOGIST PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KAREN A SCHULZ MP PSYCHOLOGIST PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1972180396
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/07/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
46469 KILLARNEY CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CANTON
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48188-3501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-748-5796
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
705 S MAIN ST STE 101I
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLYMOUTH
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48170-1060
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-748-5796
Provider Business Practice Location Address Fax Number:
734-468-0109
Provider Enumeration Date:
03/24/2021

Additional Information

Authorized Official

Authorized Official Last Name:
PEREZ
Authorized Official First Name:
KAREN
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
734-748-5796

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 6401002271 . This is a "LICENSED PROFESSIONAL COUNSELOR" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com