Provider Demographics
NPI:1679827034
Name:SCHULTZ, MESHIA JUNE (MA, LLPC)
Entity Type:Individual
Prefix:
First Name:MESHIA
Middle Name:JUNE
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:MA, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6121 W CENTERLINE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:MI
Mailing Address - Zip Code:48879-8256
Mailing Address - Country:US
Mailing Address - Phone:989-640-1261
Mailing Address - Fax:
Practice Address - Street 1:6121 W CENTERLINE RD
Practice Address - Street 2:
Practice Address - City:SAINT JOHNS
Practice Address - State:MI
Practice Address - Zip Code:48879-8256
Practice Address - Country:US
Practice Address - Phone:989-640-1261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-06
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012917101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional