Provider Demographics
NPI:1255622726
Name:KATHY SCHUTZ LCSW PC
Entity type:Organization
Organization Name:KATHY SCHUTZ LCSW PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ CEO
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, LCAS
Authorized Official - Phone:252-714-1755
Mailing Address - Street 1:3709 BARTON WAY
Mailing Address - Street 2:
Mailing Address - City:GRIMESLAND
Mailing Address - State:NC
Mailing Address - Zip Code:27837-9159
Mailing Address - Country:US
Mailing Address - Phone:252-714-1755
Mailing Address - Fax:
Practice Address - Street 1:702 CROMWELL DR
Practice Address - Street 2:SUITE G
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5436
Practice Address - Country:US
Practice Address - Phone:252-756-5654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2003014052084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty