Provider Demographics
NPI:1386131845
Name:KULZER, JAMIE LYNN (PHD, CRC, LPC)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LYNN
Last Name:KULZER
Suffix:
Gender:F
Credentials:PHD, CRC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:656 VILLAGE GREEN BLVD E
Mailing Address - Street 2:
Mailing Address - City:MARS
Mailing Address - State:PA
Mailing Address - Zip Code:16046-4824
Mailing Address - Country:US
Mailing Address - Phone:724-713-1167
Mailing Address - Fax:
Practice Address - Street 1:3600 ATWOOD STREET
Practice Address - Street 2:SUITE 5040 FORBES TOWER
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15260
Practice Address - Country:US
Practice Address - Phone:412-383-6602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007840101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor