Provider Demographics
NPI:1548813371
Name:SCHULTZ, SARA ZELDA (LPCC, MA, CPC)
Entity type:Individual
Prefix:
First Name:SARA ZELDA
Middle Name:
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:LPCC, MA, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6069 PROSPECT RD
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-9047
Mailing Address - Country:US
Mailing Address - Phone:720-466-5775
Mailing Address - Fax:
Practice Address - Street 1:6069 PROSPECT RD
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-9047
Practice Address - Country:US
Practice Address - Phone:720-466-5775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-21
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
COLPCC.0017773101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health