Provider Demographics
NPI:1255406765
Name:SCHULENBURG, NEIL P (PHD, LPC)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:P
Last Name:SCHULENBURG
Suffix:
Gender:M
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 WILLOW POND WAY
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525-9202
Mailing Address - Country:US
Mailing Address - Phone:912-264-3076
Mailing Address - Fax:912-264-0679
Practice Address - Street 1:400 GLOUCESTER ST
Practice Address - Street 2:SUITE 200
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-7011
Practice Address - Country:US
Practice Address - Phone:912-264-3076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003763101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional