Provider Demographics
NPI:1982242483
Name:SCHULTZ, ANGEL J (LCSW, LCDP, CPRS)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:J
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:LCSW, LCDP, CPRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 NORWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02905-3923
Mailing Address - Country:US
Mailing Address - Phone:401-422-9065
Mailing Address - Fax:401-921-1415
Practice Address - Street 1:178 NORWOOD AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02905-3923
Practice Address - Country:US
Practice Address - Phone:401-422-9065
Practice Address - Fax:401-921-1415
Is Sole Proprietor?:No
Enumeration Date:2019-12-16
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICDP00825101YA0400X
RI1041C0700X
RICSW032681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)