Provider Demographics
NPI:1467684936
Name:SCHULTZ, BARBARA A (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:A
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46805-5407
Mailing Address - Country:US
Mailing Address - Phone:260-484-4153
Mailing Address - Fax:260-496-5996
Practice Address - Street 1:2525 LAKE AVE
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46805-5407
Practice Address - Country:US
Practice Address - Phone:260-484-4153
Practice Address - Fax:260-496-5996
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004186A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical