Provider Demographics
NPI:1033327135
Name:TESCH VON CULTZ, HEINRICH PETER II (LIPC LIMFT MAC LPC)
Entity Type:Individual
Prefix:
First Name:HEINRICH
Middle Name:PETER
Last Name:TESCH VON CULTZ
Suffix:II
Gender:M
Credentials:LIPC LIMFT MAC LPC
Other - Prefix:
Other - First Name:BARRY
Other - Middle Name:
Other - Last Name:TESH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1638 NORWICH STREET
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520
Mailing Address - Country:US
Mailing Address - Phone:912-342-7217
Mailing Address - Fax:912-342-7216
Practice Address - Street 1:1638 NORWICH STREET
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520
Practice Address - Country:US
Practice Address - Phone:912-342-7217
Practice Address - Fax:912-342-7216
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE721 LPC101Y00000X
NE41 LIMHP101YM0800X
GALPC007110101YP2500X
NE7 LMFT106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist