Provider Demographics
NPI:1386042497
Name:SCHULTZE, AMANDA (LPC, CAMS-II)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:SCHULTZE
Suffix:
Gender:F
Credentials:LPC, CAMS-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 COOPER RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-2579
Mailing Address - Country:US
Mailing Address - Phone:770-597-1647
Mailing Address - Fax:770-962-0088
Practice Address - Street 1:299 COOPER RD
Practice Address - Street 2:SUITE A
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-2579
Practice Address - Country:US
Practice Address - Phone:770-597-1647
Practice Address - Fax:770-962-0088
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-06
Last Update Date:2014-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008195101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional