Provider Demographics
NPI:1427880392
Name:SCHULTZ, MELISSA ANN (LMSW)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24330 SPRINGBROOK DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-1936
Mailing Address - Country:US
Mailing Address - Phone:269-275-5933
Mailing Address - Fax:
Practice Address - Street 1:38807 ANN ARBOR RD STE 9
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-3896
Practice Address - Country:US
Practice Address - Phone:734-772-0148
Practice Address - Fax:734-943-6051
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010889191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical