Individual provider Active NPI

Alice J. Schultz, MS, LLP

  • Intellectual & Developmental Disabilities Psychologist
  • Detroit, MI
National Provider Identifier
1396966420
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
License
6301007626 Issued in MI
Practice address
220 Bagley
Suite 1100
Detroit, MI 48226
Phone
(313) 960-7990
Fax
(313) 961-1047
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual & Developmental Disabilities Psychologist 103TM1800X 6301007626 MI Primary

Addresses

Primary practice location

220 Bagley
Suite 1100
Detroit, MI 48226

Mailing address

1991 Harding Avenue
Ypsilanti, MI 48197
Phone (734) 483-1287

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
6301007626MIMDIntellectual & Developmental Disabilities Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Service Organization Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396966420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1991 HARDING AVENUE",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "48197",
            "telephone_number": "734-483-1287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 BAGLEY",
            "address_2": "SUITE 1100",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48226",
            "telephone_number": "313-960-7990",
            "fax_number": "313-961-1047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "ALICE",
        "middle_name": "J.",
        "credential": "MS, LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "MI",
            "license": "6301007626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.