Provider Demographics
NPI:1407017452
Name:SCHULZ, BRIANA NICHOLE (LPC / UNDER SUPER)
Entity Type:Individual
Prefix:MRS
First Name:BRIANA
Middle Name:NICHOLE
Last Name:SCHULZ
Suffix:
Gender:F
Credentials:LPC / UNDER SUPER
Other - Prefix:MS
Other - First Name:BRIANA
Other - Middle Name:NICHOLE
Other - Last Name:WENSEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC / UNDER SUPER
Mailing Address - Street 1:1602 NORTH D STREET
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-2314
Mailing Address - Country:US
Mailing Address - Phone:918-426-1614
Mailing Address - Fax:918-426-1648
Practice Address - Street 1:1602 NORTH D STREET
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-2314
Practice Address - Country:US
Practice Address - Phone:918-426-1614
Practice Address - Fax:918-426-1648
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372600000X
OK101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No372600000XNursing Service Related ProvidersAdult Companion