Provider Demographics
NPI:1619120482
Name:SCHILTZ, STEPHEN JOSEPH (LCSW)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:JOSEPH
Last Name:SCHILTZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 W SPEEDWAY BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-7686
Mailing Address - Country:US
Mailing Address - Phone:520-623-0344
Mailing Address - Fax:520-770-8578
Practice Address - Street 1:140 W SPEEDWAY BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-7686
Practice Address - Country:US
Practice Address - Phone:520-623-0344
Practice Address - Fax:520-770-8578
Is Sole Proprietor?:No
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-3535101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ106009Medicare PIN