Provider Demographics
NPI:1689809253
Name:SCHULZ, SUSAN EILEEN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:EILEEN
Last Name:SCHULZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:30 E 33RD AVE UNIT 50013
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-0865
Mailing Address - Country:US
Mailing Address - Phone:541-521-5852
Mailing Address - Fax:541-600-8873
Practice Address - Street 1:433 W 10TH AVE STE 202
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3047
Practice Address - Country:US
Practice Address - Phone:541-521-5852
Practice Address - Fax:541-600-8873
Is Sole Proprietor?:No
Enumeration Date:2009-05-26
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL21901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical