Provider Demographics
NPI:1447608146
Name:RENEE LYNNE SCHULZE
Entity Type:Organization
Organization Name:RENEE LYNNE SCHULZE
Other - Org Name:NEWBURY FAMILY COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:SCHULZE
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:802-299-7654
Mailing Address - Street 1:2111 ROUTE 302
Mailing Address - Street 2:
Mailing Address - City:WELLS RIVER
Mailing Address - State:VT
Mailing Address - Zip Code:05081-9738
Mailing Address - Country:US
Mailing Address - Phone:802-299-7654
Mailing Address - Fax:
Practice Address - Street 1:4628 MAIN ST S
Practice Address - Street 2:
Practice Address - City:NEWBURY
Practice Address - State:VT
Practice Address - Zip Code:05051-9712
Practice Address - Country:US
Practice Address - Phone:802-299-7654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-03
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT089-0000934OtherVT LICSW
NH3071684Medicaid
VT59019OtherBOARD CERTIFICATION
VT1011218Medicaid
NH00345002AT 5:15Medicare PIN