Provider Demographics
NPI:1902324320
Name:VON SCHULZ, DEREK (MA, LPC)
Entity type:Individual
Prefix:
First Name:DEREK
Middle Name:
Last Name:VON SCHULZ
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 E HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5010
Mailing Address - Country:US
Mailing Address - Phone:303-482-7628
Mailing Address - Fax:
Practice Address - Street 1:2401 S DOWNING ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5811
Practice Address - Country:US
Practice Address - Phone:303-997-2468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-06
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor