Provider Demographics
NPI:1942636220
Name:SCHULDT, WOODY BUCHANAN (LMHC)
Entity Type:Individual
Prefix:
First Name:WOODY
Middle Name:BUCHANAN
Last Name:SCHULDT
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2778 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32205-8227
Mailing Address - Country:US
Mailing Address - Phone:904-225-8280
Mailing Address - Fax:
Practice Address - Street 1:463142 STATE ROAD 200
Practice Address - Street 2:
Practice Address - City:YULEE
Practice Address - State:FL
Practice Address - Zip Code:32097-5554
Practice Address - Country:US
Practice Address - Phone:904-225-8280
Practice Address - Fax:904-225-8232
Is Sole Proprietor?:No
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12051101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health