Provider Demographics
NPI:1609344589
Name:SCHULZE, CAROLYN DIANE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:DIANE
Last Name:SCHULZE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:CAROLYN
Other - Middle Name:DIANE
Other - Last Name:TRUMBLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7910 COUNTY ROAD 252
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:FL
Mailing Address - Zip Code:32060-6860
Mailing Address - Country:US
Mailing Address - Phone:386-688-3979
Mailing Address - Fax:
Practice Address - Street 1:260 S MARION AVE STE 135
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-7000
Practice Address - Country:US
Practice Address - Phone:386-697-8842
Practice Address - Fax:386-406-8340
Is Sole Proprietor?:No
Enumeration Date:2018-11-08
Last Update Date:2023-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW155321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical