Provider Demographics
NPI:1639103542
Name:SCHULZ, TATJANA KATJA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:TATJANA
Middle Name:KATJA
Last Name:SCHULZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 GRAHAM TRL
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-6920
Mailing Address - Country:US
Mailing Address - Phone:386-313-1095
Mailing Address - Fax:
Practice Address - Street 1:25 GRAHAM TRL
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-6920
Practice Address - Country:US
Practice Address - Phone:480-688-2410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical