Basic Information
| Provider Information | |||||||||
| NPI: | 1275525313 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHULZE | ||||||||
| FirstName: | REGINA | ||||||||
| MiddleName: | LYNNE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | CMSW LMHP LISW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7787 HOWARD ST | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681145426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4023426943 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 515 E BROADWAY | ||||||||
| Address2: | |||||||||
| City: | COUNCIL BLUFFS | ||||||||
| State: | IA | ||||||||
| PostalCode: | 515034419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7123221407 | ||||||||
| FaxNumber: | 7123226833 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2005 | ||||||||
| LastUpdateDate: | 03/16/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | LMHP 1713 | NE | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health | 1041C0700X | LISW #06270 | IA | N | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.