Provider Demographics
NPI:1518437292
Name:SCHULTES, DEANNA (CERTIFIED COUNSELOR)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:SCHULTES
Suffix:
Gender:F
Credentials:CERTIFIED COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 BARKER DR
Mailing Address - Street 2:
Mailing Address - City:MOODY
Mailing Address - State:AL
Mailing Address - Zip Code:35004-3300
Mailing Address - Country:US
Mailing Address - Phone:205-478-3200
Mailing Address - Fax:
Practice Address - Street 1:1607 MARTIN ST S STE 6
Practice Address - Street 2:
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35128-2373
Practice Address - Country:US
Practice Address - Phone:205-478-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL995908101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL995908OtherNBCC