Provider Demographics
NPI:1538181789
Name:SCHULTZ, LAHOMA ANN (PHDLPC, CRC)
Entity type:Individual
Prefix:MS
First Name:LAHOMA
Middle Name:ANN
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:PHDLPC, CRC
Other - Prefix:DR
Other - First Name:LAHOMA
Other - Middle Name:
Other - Last Name:SCHULTZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:200 WHITE EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:PONCA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:74601-8315
Mailing Address - Country:US
Mailing Address - Phone:580-765-2501
Mailing Address - Fax:580-765-6348
Practice Address - Street 1:200 WHITE EAGLE DR
Practice Address - Street 2:
Practice Address - City:PONCA CITY
Practice Address - State:OK
Practice Address - Zip Code:74601-8315
Practice Address - Country:US
Practice Address - Phone:580-765-2501
Practice Address - Fax:580-765-6348
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP0507044101YP2500X
OK1784101YP2500X
AR11-08P103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional