Provider Demographics
NPI:1548905201
Name:SCHOULTZ, KARINA ANNE (LCSW)
Entity type:Individual
Prefix:
First Name:KARINA
Middle Name:ANNE
Last Name:SCHOULTZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2631 S EDISON ST
Mailing Address - Street 2:
Mailing Address - City:GRATON
Mailing Address - State:CA
Mailing Address - Zip Code:95444-9304
Mailing Address - Country:US
Mailing Address - Phone:410-241-6001
Mailing Address - Fax:
Practice Address - Street 1:2631 S EDISON ST
Practice Address - Street 2:
Practice Address - City:GRATON
Practice Address - State:CA
Practice Address - Zip Code:95444-9304
Practice Address - Country:US
Practice Address - Phone:410-241-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA747151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical