Provider Demographics
NPI:1487041703
Name:SCHULZ, LAURA (MA, PHD, LMHC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:SCHULZ
Suffix:
Gender:F
Credentials:MA, PHD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15510 123RD AVENUE CT E
Mailing Address - Street 2:
Mailing Address - City:SOUTH HILL
Mailing Address - State:WA
Mailing Address - Zip Code:98374-9691
Mailing Address - Country:US
Mailing Address - Phone:509-413-2473
Mailing Address - Fax:
Practice Address - Street 1:15510 123RD AVENUE CT E
Practice Address - Street 2:
Practice Address - City:SOUTH HILL
Practice Address - State:WA
Practice Address - Zip Code:98374-9691
Practice Address - Country:US
Practice Address - Phone:509-413-2473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-24
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60801673101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health