Provider Demographics
NPI:1003853367
Name:SCHULTZ, LINDA (MS PSYCHOLOGIST)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:MS PSYCHOLOGIST
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:DAILY MECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1432 SOUTHWEST BLVD
Mailing Address - Street 2:CAPITAL REGION PSYCHOLOGY & COUNSELING
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109
Mailing Address - Country:US
Mailing Address - Phone:573-632-5560
Mailing Address - Fax:573-632-5875
Practice Address - Street 1:1432 SOUTHWEST BLVD
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109
Practice Address - Country:US
Practice Address - Phone:573-632-5560
Practice Address - Fax:573-632-5875
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01340103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO493345003Medicaid
MO109947OtherBCBS