Provider Demographics
NPI:1194185199
Name:SCHULTZ, REBECCA COOKE (LPC-AT, ATR-BC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:COOKE
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:LPC-AT, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:493 PROSPECT PL APT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-4182
Mailing Address - Country:US
Mailing Address - Phone:832-298-7466
Mailing Address - Fax:
Practice Address - Street 1:493 PROSPECT PL APT 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-4182
Practice Address - Country:US
Practice Address - Phone:832-298-7466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-03
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72854101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional