Provider Demographics
NPI:1003102500
Name:SCHMIDT, NANCY J (PHD, CADC, MAC, CHES)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:J
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:PHD, CADC, MAC, CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-2116
Mailing Address - Country:US
Mailing Address - Phone:208-263-2802
Mailing Address - Fax:
Practice Address - Street 1:30410 HIGHWAY 200
Practice Address - Street 2:
Practice Address - City:PONDERAY
Practice Address - State:ID
Practice Address - Zip Code:83852-9601
Practice Address - Country:US
Practice Address - Phone:208-263-7101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID11540040101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)