Provider Demographics
NPI:1467163428
Name:SCHULTZ, SPENCER STEVEN (LMSW)
Entity Type:Individual
Prefix:MR
First Name:SPENCER
Middle Name:STEVEN
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2621 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-6216
Mailing Address - Country:US
Mailing Address - Phone:315-731-0665
Mailing Address - Fax:
Practice Address - Street 1:2621 GENESEE ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-6216
Practice Address - Country:US
Practice Address - Phone:315-731-0665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY108496104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker