Provider Demographics
NPI:1861589145
Name:MARCIA SCHULTZ, PSY.D., INC.
Entity type:Organization
Organization Name:MARCIA SCHULTZ, PSY.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:954-649-1957
Mailing Address - Street 1:9951 NW 38TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-2830
Mailing Address - Country:US
Mailing Address - Phone:954-752-7707
Mailing Address - Fax:954-752-9562
Practice Address - Street 1:3111 N UNIVERSITY DR
Practice Address - Street 2:400
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5086
Practice Address - Country:US
Practice Address - Phone:954-649-1957
Practice Address - Fax:954-752-9562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4717103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73941OtherBLUE CROSS
FLK7420Medicare ID - Type UnspecifiedMEDICARE
FL=========Medicare UPIN