Provider Demographics
NPI:1265459903
Name:SCHULZ, LORETTA (LPC)
Entity Type:Individual
Prefix:
First Name:LORETTA
Middle Name:
Last Name:SCHULZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 HISTORY DR
Mailing Address - Street 2:
Mailing Address - City:OAKTON
Mailing Address - State:VA
Mailing Address - Zip Code:22124-2209
Mailing Address - Country:US
Mailing Address - Phone:703-969-0213
Mailing Address - Fax:703-860-5898
Practice Address - Street 1:9675 MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-3762
Practice Address - Country:US
Practice Address - Phone:703-969-0213
Practice Address - Fax:703-860-5898
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003236101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7262408OtherAETNA INSURANCE COMPANY
MD21132OtherKAISER PERMANENTE