Basic Information
Provider Information
NPI: 1851512107
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHULTZ
FirstName: SAUNDRA
MiddleName: LEANNE
NamePrefix: MRS.
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2012 LAUREL RD
Address2:  
City: BISMARCK
State: AR
PostalCode: 719296958
CountryCode: US
TelephoneNumber: 5018446058
FaxNumber:  
Practice Location
Address1: 3399 FINCH RD
Address2:  
City: BISMARCK
State: AR
PostalCode: 71929
CountryCode: US
TelephoneNumber: 5018653363
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/02/2007
LastUpdateDate: 06/13/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500XA0309083ARY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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