Provider Demographics
NPI:1710948120
Name:SCHULTZ, JAMES ALFRED (LPC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ALFRED
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1932 BOWSPRIT DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-6728
Mailing Address - Country:US
Mailing Address - Phone:970-691-1112
Mailing Address - Fax:
Practice Address - Street 1:155 N COLLEGE AVE STE 226
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-2455
Practice Address - Country:US
Practice Address - Phone:970-691-1112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4199101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional