Provider Demographics
NPI:1891076311
Name:SCHULZ, AUTUMN DAWN (LCPC-C, LADC)
Entity Type:Individual
Prefix:MS
First Name:AUTUMN
Middle Name:DAWN
Last Name:SCHULZ
Suffix:
Gender:F
Credentials:LCPC-C, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6126
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-6126
Mailing Address - Country:US
Mailing Address - Phone:207-344-4299
Mailing Address - Fax:
Practice Address - Street 1:173 GRAY RD
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-2514
Practice Address - Country:US
Practice Address - Phone:207-344-4299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC3860101YP2500X, 101YP2500X
MEXL3505101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health