Provider Demographics
NPI:1033700273
Name:SCHUTZBANK, NICOLE (LPC, LCAT, ATR-BC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:SCHUTZBANK
Suffix:
Gender:F
Credentials:LPC, LCAT, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:469 S CONVENT AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85701-2261
Mailing Address - Country:US
Mailing Address - Phone:520-355-0814
Mailing Address - Fax:
Practice Address - Street 1:469 S CONVENT AVE APT 1
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85701-2261
Practice Address - Country:US
Practice Address - Phone:520-355-0814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-31
Last Update Date:2023-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-20394101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional