Provider Demographics
NPI:1811958762
Name:SCHILTZ, SUSAN KATHRYN (PHD LMHC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:KATHRYN
Last Name:SCHILTZ
Suffix:
Gender:F
Credentials:PHD LMHC
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:K
Other - Last Name:SCHILTZ-DAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, LMHC
Mailing Address - Street 1:8837 OXLEY PL
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-2903
Mailing Address - Country:US
Mailing Address - Phone:515-419-6249
Mailing Address - Fax:
Practice Address - Street 1:1200 VALLEY WEST DR STE 404
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1905
Practice Address - Country:US
Practice Address - Phone:515-419-6249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-30
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA38101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health