Provider Demographics
NPI:1972008027
Name:SCHULTZ, SIMONE (LMHC,LMSW, LPC,CASAC)
Entity type:Individual
Prefix:
First Name:SIMONE
Middle Name:
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:LMHC,LMSW, LPC,CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 FLATBUSH AVE UNIT 340152
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4530
Mailing Address - Country:US
Mailing Address - Phone:718-664-4689
Mailing Address - Fax:
Practice Address - Street 1:2222 FLATBUSH AVE UNIT 340152
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-4530
Practice Address - Country:US
Practice Address - Phone:718-664-4689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011012101YM0800X
NY34279101YA0400X
SC9014101YP2500X
NJ119954101YP2500X
NY119954104100000X
PAPC016002101YP2500X
TX92074101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker