Provider Demographics
NPI:1306425152
Name:SCHULTZ, ANGELA WIGNALL (LCSW, LICSW)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:WIGNALL
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:LCSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1246 W 710 S
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84321-6050
Mailing Address - Country:US
Mailing Address - Phone:541-625-0028
Mailing Address - Fax:
Practice Address - Street 1:HEALTH HEALING AND WHOLENESS
Practice Address - Street 2:517 WEST 100 NORTH SUITE 202
Practice Address - City:PROVIDENCE
Practice Address - State:UT
Practice Address - Zip Code:84332
Practice Address - Country:US
Practice Address - Phone:435-915-6915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT365340-35011041C0700X
COCSW.099316561041C0700X
RIISW043961041C0700X
FLTPSW52131041C0700X
MALICSW11405541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical