Provider Demographics
NPI:1073981635
Name:SCHULTZ, HILLARY (PCC-S)
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:PCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3681 GREEN RD STE 404
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5716
Mailing Address - Country:US
Mailing Address - Phone:216-342-5484
Mailing Address - Fax:216-450-1126
Practice Address - Street 1:3681 GREEN RD STE 404
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5716
Practice Address - Country:US
Practice Address - Phone:216-342-5484
Practice Address - Fax:216-450-1126
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-11
Last Update Date:2020-09-16
Deactivation Date:2016-03-15
Deactivation Code:
Reactivation Date:2017-04-26
Provider Licenses
StateLicense IDTaxonomies
OHE4260101Y00000X, 101YA0400X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0222270Medicaid