Provider Demographics
NPI:1609378058
Name:PATRICK SCHULTZ LLC
Entity Type:Organization
Organization Name:PATRICK SCHULTZ LLC
Other - Org Name:MILWAUKEE COUNSELOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOTHERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPC NCC
Authorized Official - Phone:262-236-5135
Mailing Address - Street 1:11345 N PORT WASHINGTON RD STE 204
Mailing Address - Street 2:
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53092-3411
Mailing Address - Country:US
Mailing Address - Phone:262-236-5135
Mailing Address - Fax:
Practice Address - Street 1:11345 N PORT WASHINGTON RD STE 204
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-3411
Practice Address - Country:US
Practice Address - Phone:262-236-5135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-01
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5299-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI50241041Medicaid