Provider Demographics
NPI:1134645237
Name:SCHULZ, JEFFREY BRANDT (LPC, LCDC)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:BRANDT
Last Name:SCHULZ
Suffix:
Gender:M
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 NORTH ST STE B
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75961-5070
Mailing Address - Country:US
Mailing Address - Phone:936-615-0256
Mailing Address - Fax:
Practice Address - Street 1:412 NORTH ST STE B
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75961-5070
Practice Address - Country:US
Practice Address - Phone:936-615-0256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11737101YA0400X
TX69691101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health