Provider Demographics
NPI:1174075592
Name:SCHULTZ, CHRISTINA MARIA (LPC)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MARIA
Last Name:SCHULTZ
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 1:334 WILLOW WINDS PKWY
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-7268
Mailing Address - Country:US
Mailing Address - Phone:571-882-2925
Mailing Address - Fax:
Practice Address - Street 1:8019 OAK BRIDGE LN
Practice Address - Street 2:
Practice Address - City:FAIRFAX STATION
Practice Address - State:VA
Practice Address - Zip Code:22039-3409
Practice Address - Country:US
Practice Address - Phone:571-882-2925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH24338101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0701009908OtherLICENSED PROFESSIONAL COUNSELOR
13934780OtherCAQH
FLMH24338OtherLICENSED MENTAL HEALTH COUNSELOR