Provider Demographics
NPI:1609608058
Name:SCHULTZ, KIMBERLY ELIZABETH
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ELIZABETH
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2744 MERCER RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-1453
Mailing Address - Country:US
Mailing Address - Phone:724-698-9661
Mailing Address - Fax:
Practice Address - Street 1:2744 MERCER RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-1453
Practice Address - Country:US
Practice Address - Phone:724-698-9661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)