Provider Demographics
NPI:1174774566
Name:SCHILTZ, LAURA PAULINE (LICSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:PAULINE
Last Name:SCHILTZ
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 212TH ST SW
Mailing Address - Street 2:SUITE G
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-7451
Mailing Address - Country:US
Mailing Address - Phone:425-344-7154
Mailing Address - Fax:
Practice Address - Street 1:8000 212TH ST SW
Practice Address - Street 2:SUITE G
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7451
Practice Address - Country:US
Practice Address - Phone:425-344-7154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-04
Last Update Date:2008-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW600245691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical