Provider Demographics
NPI:1750485132
Name:SCHULTZ, EMILY K (LCSW)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:K
Last Name:SCHULTZ
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 1:1835 UNION AVE
Mailing Address - Street 2:SUITE 315
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104
Mailing Address - Country:US
Mailing Address - Phone:901-762-0652
Mailing Address - Fax:901-726-4396
Practice Address - Street 1:1835 UNION AVE
Practice Address - Street 2:SUITE 315
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104
Practice Address - Country:US
Practice Address - Phone:901-762-0652
Practice Address - Fax:901-726-4396
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8221041C0700X
AR1659C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3695813Medicaid
TN3140306OtherBCBS OF TN
TN3140306OtherBCBS OF TN
TN3695813Medicare ID - Type Unspecified