Provider Demographics
NPI:1588786040
Name:SCHULZ, PENNE (LPC)
Entity type:Individual
Prefix:MS
First Name:PENNE
Middle Name:
Last Name:SCHULZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:WILLOW PARK
Mailing Address - State:TX
Mailing Address - Zip Code:76087-8886
Mailing Address - Country:US
Mailing Address - Phone:817-694-0722
Mailing Address - Fax:
Practice Address - Street 1:112 SW THOMAS ST
Practice Address - Street 2:SUITE 104
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-3818
Practice Address - Country:US
Practice Address - Phone:817-694-0722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK400101YP2500X
TX65286101YP2500X
ORC2505101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional